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

Onemanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the typical causes associated with a home packed of loud adolescent children, but because it’s the first time she will showcase her recently altered face to friends and extended family. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the outcome of half a dozen aesthetic surgeries, such as an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their twenties and thirties – significantly before a ten years before most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are built a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and drags the dermis down with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and causes laxity in the skin – alongside the widespread use of slimming medications, cut-price surgical travel, and the advancement of new, famous-figure-promoted operative methods are driving a new kind of customer towards this major operation. Statistics show an eight percent rise in facelifts over the last year in the UK; while a study revealed that the percentage of youthful candidates is growing, with one-third of procedures now conducted for patients aged 35-55.

“People are now requesting to look like the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves lifting the superficial layer, the deep plane facelift loosens the underlying structures beneath it, enabling doctors to restructure the face by repositioning the deeper tissue, and preventing the tight, stretched look sometimes wrought by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Elevating the whole facial structure as a unified block allows for a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing 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 reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

Whether injectable substances ever fully dissolve has long been a point of contention 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 call ‘pillow face’ is additionally the reality that to some extent, the face gets slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Although studies into the area is preliminary, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would never use fillers in a client because of the risks they pose. “Many surgeons don’t want to talk about this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a face and neck lift could be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a list of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facelift was the correct option for the laxity she was experiencing in her face. She booked a forehead lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d touched down solo in Turkey, she opted to include a lip lift. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|