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

Onemanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. Not for the usual causes associated with a home packed of loud preteen children, but because it’s the first time she will debut her recently altered face to friends and extended family. “Obviously I’m going to tell all guests as they come in, ‘Just so you know, this is not the way I appear,’” states the 30-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – look is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals electing to have a rhytidectomy in their 20s and 30s – well over a ten years before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are eager to highlight the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Our faces are built a little like onion layers,” explains based in Kent 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 structural foundation of the face. And that’s what causes aging; that is what loosens and sags and drags the dermis downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an conscientious surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and causes looseness in the dermis – alongside the widespread use of slimming medications, low-cost medical tourism, and the advancement of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this invasive surgery. Reports indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a survey revealed that the portion of youthful candidates is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are asking now to look like the best version of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails elevating the SMAS, the deep plane facelift loosens the underlying structures beneath it, enabling doctors to restructure the face by repositioning the underlying layers, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting result. It additionally implies that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I underwent it because the filler harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t think I would be where I’m at currently.”

If injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the fact that to some extent, the face becomes slightly fluid-filled because its ability to drain lymphatic fluid has been reduced.” Although research into the topic is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies initiated. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would avoid using injectables in a client because of the risks they pose. “Many doctors avoid discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she needed to finally step off 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 patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d arrived alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|