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

Onemanda Preisinger experiences worry about her child’s impending 13th birthday party. It’s not due to the typical reasons associated with a home packed of clamorous preteen children, but since it’s the initial occasion she will reveal her new face to acquaintances and relatives. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not how I look,’” states the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the outcome of half a dozen aesthetic surgeries, including an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even open my eyes. That’s how swollen I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Our faces are built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and drags the skin down with it.”

You endanger operating on individuals that have deeper issues. It’s not advisable for an conscientious surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and leads to looseness in the dermis – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are attracting a new kind of patient towards this invasive surgery. Reports show an 8% increase in facelifts over the past 12 months in the UK; while a survey found that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails elevating the superficial layer, the deep plane facelift releases the facial ligaments underneath, allowing surgeons to restructure the face by moving the deeper tissue, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a unified block allows for a authentic-appearing and longer-lasting result. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at least not at the age of 30. But years of 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 wanted to look young,” she clarifies. “I underwent it because the injectable harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

If dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely fully dissipate,” says Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly waterlogged because its capacity to remove lymphatic fluid has been reduced.” Though research into the area is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and further research announced. One highly regarded face specialist, commenting on the condition of anonymity, says he would avoid using fillers in a client because of the risks they present. “A lot of surgeons don’t want to discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – particularly when it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a facial and neck surgery could be what she required to exit the injectable hamster wheel. Two years later, she found herself selecting from a selection of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her doctor recommended that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a brow lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d touched down alone in the country, she decided to add a mouth enhancement. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|