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

Onemanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the usual causes related to a home packed of loud adolescent kids, but because it’s the first time she will showcase her recently altered face to acquaintances and relatives. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not the way I look,’” states the thirty-year-old property agent from Southern Florida.

How she looks is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the outcome of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via video call from her home. “I needed to inform 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 cosmetic specialists, Preisinger is one of a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade before most doctors’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are built a bit like onion layers,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and pulls the skin down with it.”

You endanger operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and causes laxity in the dermis – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are attracting a different type of customer towards this major operation. Reports show an eight percent rise in facial lifts over the past 12 months in the UK; while a study revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged 35-55.

“People are asking now to look like the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift loosens the facial ligaments underneath, enabling surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a passenger.” Elevating the whole facial structure as a unified block results in a authentic-appearing and longer-lasting 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 “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the thirty years old. But long-term using injectable gels in an effort at “facial balancing” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the filler harmed my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

If injectable substances completely disappear has long been a debated topic in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its capacity to remove bodily fluid has been reduced.” Although studies into the area is preliminary, warnings on injectables’ possible effects on the lymphatic system have been issued, and further research initiated. An esteemed face specialist, speaking anonymously, mentioned he would never use fillers in a patient because of the risks they present. “Many surgeons don’t want to talk about this, because the companies who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started 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 local plastic surgeon in Florida proposed that a face and neck lift might be what she required to exit the injectable hamster wheel. After 24 months, she ended up selecting from a selection of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The eve of her surgery, 24 hours post she’d touched down solo in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|