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

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday party. Not for the typical causes related to a home packed of clamorous preteen children, but since it’s the initial occasion she will reveal her recently altered face to acquaintances and relatives. “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 real estate agent from south Florida.

How she looks is, well, a little startling – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the result of half a dozen aesthetic surgeries, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of individuals electing to undergo a facelift in their 20s and 30s – well over a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Our faces are structured a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of supportive 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 becomes lax and pulls the dermis downward with it.”

You endanger performing surgery on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and causes looseness in the dermis – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are driving a new kind of patient towards this major operation. Statistics indicate an eight percent rise in facelifts over the last year in the UK; while a study found that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and obviously the methods are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails elevating the superficial layer, the deep plane facelift releases the underlying structures beneath it, allowing doctors to restructure the face by moving the deeper tissue, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive numerous requests from clients 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 years of using injectable gels in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the filler harmed my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be where I’m at currently.”

If dermal fillers completely disappear has historically been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the reality that in a sense, the face becomes slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Although research into the area is early-stage, warnings on injectables’ possible effects on the body’s drainage have been released, and further research initiated. One highly regarded face specialist, commenting anonymously, mentioned he would avoid using injectables in a patient because of the risks they present. “Many doctors don’t want to discussing this, because the companies who make filler can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep replenishing it – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up selecting from a list of suggested accommodations in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d arrived alone in Turkey, she decided to add a lip lift. “Then he stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|