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

Onemanda Preisinger experiences worry about her child’s upcoming 13th birthday party. Not for the usual causes associated with a house full of loud adolescent children, but because it’s the initial occasion she will debut her new face to friends and relatives. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not the way I look,’” says the thirty-year-old property agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – look is the result of half a dozen aesthetic surgeries, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even open my eyes. That indicates swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of people choosing to undergo a rhytidectomy in their twenties and thirties – well over a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a bit concerned when I observe individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “Human faces are built a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose 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 down with it.”

You risk performing surgery on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels expands the face and causes looseness in the skin – alongside the common adoption of slimming medications, cut-price surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are driving a different type of customer towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the portion of younger facelift patients is increasing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

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

Advanced Lifting Method

Where a more traditional facelift involves lifting the SMAS, the deep plane facelift releases the facial ligaments beneath it, allowing doctors to restructure the face by moving the underlying layers, and avoiding the taut, pulled look 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 plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing and more durable outcome. It also means that the surgery is no longer being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” she says. “I underwent it because the injectable harmed my face. I wish I had never using it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face becomes slightly waterlogged because its ability to drain lymphatic fluid has been diminished.” Though research into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and further research initiated. An esteemed face specialist, speaking anonymously, mentioned he would never use injectables in a patient because of the dangers they pose. “Many surgeons don’t want to talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she needed to exit the injectable hamster wheel. Two years later, she ended up selecting from a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facelift was the right solution 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 alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|