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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual causes related to a home packed of clamorous preteen children, but since it’s the first time she will showcase her new face to acquaintances and extended family. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not the way I look,’” says the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – appearance is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to 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 jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of people choosing to have a facelift in their twenties and thirties – significantly before a decade before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that start to sag as we age. “Our faces are structured a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and drags the dermis down with it.”

You risk performing surgery on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to laxity in the skin – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of new, celebrity-endorsed operative methods are driving a different type of customer towards this invasive surgery. Statistics show an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the percentage of youthful candidates is growing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy entails elevating the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, enabling doctors to restructure the face by moving the deeper tissue, and preventing the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a single unit results in a authentic-appearing and longer-lasting result. 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’re getting numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the injectable ruined my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the reality that to some extent, the face gets slightly fluid-filled because its ability to remove bodily fluid has been diminished.” Though studies into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and further research announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using injectables in a client because of the risks they present. “Many surgeons avoid discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s been told accounts, he says, 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 had to keep adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a face and neck lift might be what she required to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her operation, 24 hours post she’d arrived alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|