‘My Eyes Were So Puffy I Couldn’t Even Unseal Them’

Onemanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. It’s not due to the usual causes related to a home packed of loud adolescent children, but since it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I look,’” states the 30-year-old property agent from Southern Florida.

How she looks is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of six cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of people choosing to undergo a facelift in their 20s and 30s – well over a decade before most doctors’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Human faces are structured a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and drags the dermis downward with it.”

You endanger operating on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and leads to laxity in the skin – combined with the widespread use of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are attracting a different type of patient towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the past 12 months in the UK; while a survey revealed that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are asking now to appear as the optimal form of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails lifting the SMAS, the comprehensive lift loosens the underlying structures underneath, allowing doctors to restructure the face by moving the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a passenger.” Lifting the whole facial structure as a single unit results in a authentic-appearing and more durable outcome. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she says. “I did it because the filler harmed my face. I regret ever done it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the reality that to some extent, the face becomes somewhat fluid-filled because its ability to drain bodily fluid has been reduced.” Although research into the topic is early-stage, warnings on injectables’ potential impact on the lymphatic system have been issued, and additional studies announced. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would avoid using fillers in a client because of the risks they pose. “A lot of doctors avoid talk about this, because the companies who make filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facelift was the correct option for the looseness she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her surgery, 24 hours post she’d arrived solo in Turkey, she decided to add a lip lift. “Then he said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|