‘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 causes associated with a home packed of loud preteen children, but because it’s the initial occasion she will debut her new face to friends and relatives. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I look,’” says the thirty-year-old property agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of people choosing to have a facelift in their 20s and 30s – significantly before a ten years before most doctors’ typical patient age range of forty to sixty. (Though many specialists are eager to highlight the industry edict of: “We address heredity, not years.”) “I have 28-year-olds requesting 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 very significant surgery, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Our faces are built a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what loosens and sags and drags the skin down with it.”

You endanger operating on people that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and causes laxity in the skin – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the advancement of novel, famous-figure-promoted surgical techniques are driving a new kind of customer towards this major operation. Reports indicate an 8% increase in facelifts over the last year in the UK; while a study revealed that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are asking now to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails lifting the superficial layer, the comprehensive lift releases the underlying structures beneath it, enabling surgeons to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Lifting the whole facial structure as a single unit results in a authentic-appearing and more durable result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But long-term using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the filler ruined my face. I wish I had never using it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly fluid-filled because its ability to remove bodily fluid has been diminished.” Although studies into the topic is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and further research initiated. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would avoid using fillers in a client because of the dangers they present. “A lot of surgeons don’t want to discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up selecting from 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 – commonly called eyelid surgery – but her doctor recommended that a facial lift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d arrived alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|