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

Onemanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the usual causes related to a home packed of loud adolescent 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 everyone as they come in, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old property agent from south Florida.

Her appearance is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – look is the result of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a growing number of people electing to have a facelift in their twenties and thirties – well over a ten years before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have 28-year-olds asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a facelift, lifts the ligaments in the face that start to sag as we age. “Human faces are structured a little like onion layers,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that is what becomes lax and drags the skin downward with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and leads to laxity in the dermis – alongside the common adoption of slimming medications, low-cost surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are driving a different type of patient towards this invasive surgery. Reports indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of youthful candidates is growing, with 32% of facelifts now performed on individuals aged 35-55.

“People are now requesting to appear as the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy entails elevating the superficial layer, the deep plane facelift loosens the facial ligaments underneath, enabling surgeons to restructure the face by moving the deeper tissue, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing stress 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 deeper tissue that is adjusted. The skin follows along as a passenger.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and longer-lasting outcome. It also means that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I underwent it because the injectable harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”

If dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face becomes somewhat fluid-filled because its capacity to drain lymphatic fluid has been diminished.” Although research into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been released, and further research initiated. One highly regarded facial plastic surgeon, commenting anonymously, says he would never use fillers in a patient because of the dangers they present. “Many surgeons avoid talk about this, because the companies who produce filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

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 just 28 when a local plastic surgeon in Florida suggested that a face and neck lift might be what she needed to exit the cycle of treatments. 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.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facelift was the correct option for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her surgery, one day after she’d arrived alone in the country, she opted to include a lip lift. “Then he stated, ‘We will lift the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she recalls. She paid $22,000 (£16,500) for the half-day operation, including a three-day|