‘My Eyes Were So Puffy I Was Unable to Even Open Them’

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. Not for the usual reasons associated with a house full of clamorous adolescent children, but since it’s the first time she will showcase her new face to friends and extended family. “Obviously I’m going to tell all guests as they come in, ‘Just so you know, this is not how I appear,’” states the thirty-year-old real estate agent from south Florida.

How she looks is, well, a little startling – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, temporary – look is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of people electing to undergo a facelift in their twenties and thirties – well over a ten years before most doctors’ usual candidate age of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the tissues in the face that begin to droop as we age. “Our faces are structured a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and drags the dermis downward with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and causes looseness in the skin – alongside the common adoption of slimming medications, low-cost surgical travel, and the development of novel, famous-figure-promoted operative methods are attracting a different type of customer towards this major operation. Statistics indicate an 8% increase in facelifts over the last year in the United Kingdom; while a survey revealed that the percentage of youthful candidates is increasing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are now requesting to look like the best version of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves lifting the SMAS, the comprehensive lift loosens the facial ligaments beneath it, allowing surgeons to reshape the face by moving the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Lifting the whole facial structure as a single unit results in a more natural-looking 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 aesthetics industry describes it – but for “beautification” and contouring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But years of using injectable gels in an effort at “facial balancing” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I underwent it because the filler ruined my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

Whether dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Research have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the reality that to some extent, the face becomes somewhat waterlogged because its capacity to remove lymphatic fluid has been reduced.” Though research into the area is early-stage, warnings on dermal fillers’ potential impact on the body’s drainage have been released, and further research announced. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would avoid using fillers in a patient because of the risks they present. “Many surgeons avoid talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons facing court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – especially as 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 face and neck lift might be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facial lift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a neck lift. The day before her surgery, 24 hours post she’d arrived solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|