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

Onemanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the typical causes associated with a home packed of clamorous adolescent kids, but because it’s the initial occasion she will debut her recently altered face to friends and extended family. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not how I look,’” says the thirty-year-old property agent from south Florida.

Her appearance is, well, a little startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My spouse became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a growing number of individuals choosing to undergo a rhytidectomy in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of 40 to 60. (Though many specialists are eager to highlight the industry edict of: “We address heredity, not years.”) “I have 28-year-olds asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “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 connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and pulls the dermis down with it.”

You risk performing surgery on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers expands the face and leads to looseness in the dermis – combined with the widespread use of slimming medications, low-cost medical tourism, and the advancement of novel, celebrity-endorsed surgical techniques are driving a new kind of patient towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the portion of youthful candidates is growing, 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 methods are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy entails elevating the SMAS, the comprehensive lift releases the facial ligaments underneath, allowing doctors to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a passenger.” Elevating 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 not just being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I underwent it because the injectable ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be in this situation right now.”

If injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the reality 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 injectables’ possible effects on the lymphatic system have been released, and further research announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would never use injectables in a patient because of the dangers they present. “Many doctors don’t want to discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep adding more – especially as it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a face and neck lift might be what she required to finally step off the cycle of treatments. Two years later, she ended up choosing between a list of recommended hotels in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – 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 arranged a brow lift, a cheek lift and a neck lift. The day before her surgery, one day after she’d arrived solo in the country, she decided to add a mouth enhancement. “Then he stated, ‘We will lift the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|