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

Onemanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the usual reasons related to a house full of loud adolescent kids, but because it’s the first time she will debut her recently altered face to acquaintances and relatives. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not the way I appear,’” says the 30-year-old property agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of individuals choosing to undergo a facelift in their 20s and 30s – well over a ten years prior to most doctors’ typical patient age range of 40 to 60. (Though most surgeons are eager to highlight the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds asking for facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a bit concerned when I see people 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,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and drags the dermis down with it.”

You endanger operating on people that have deeper issues. 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 laxity in the skin – combined with the common adoption of slimming medications, low-cost surgical travel, and the development of new, celebrity-endorsed surgical techniques are attracting a new kind of customer towards this major operation. Statistics indicate an eight percent rise in facelifts over the past 12 months in the UK; while a study revealed that the percentage of youthful candidates is growing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the best version of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the facial ligaments underneath, allowing doctors to restructure the face by moving the deeper tissue, and preventing 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 deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “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 results in a more natural-looking and longer-lasting outcome. It additionally implies that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

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” implied that by the time she reached 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 ruined my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

Whether injectable substances completely disappear has historically been a debated topic in the cosmetic field. “Research have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. 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 drain bodily fluid has been reduced.” Although studies into the topic is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, speaking on the condition of anonymity, mentioned he would never use injectables in a patient because of the dangers they present. “Many surgeons don’t want to discussing this, because the companies who make filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she had to keep adding more – particularly when it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d touched down solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|