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

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday party. Not for the typical reasons associated with a home packed of loud preteen kids, but because it’s the first time she will debut her recently altered face to acquaintances and relatives. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the 30-year-old property agent from south Florida.

How she looks is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of six aesthetic surgeries, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even open my eyes. That indicates swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of individuals electing to undergo a facelift in their twenties and thirties – significantly before a ten years before most doctors’ usual candidate age of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Human faces are built a bit like onion layers,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that is what causes aging; that is what becomes lax and drags the skin downward with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels expands the face and causes looseness in the dermis – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a different type of patient towards this invasive surgery. Statistics show an eight percent rise in facial lifts over the last year in the UK; while a study revealed that the percentage of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“People are now requesting to appear as the optimal form of themselves and naturally the methods are evolving,” says Orfaniotis. Currently, 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.

Deep Plane Technique

While a conventional facelift entails elevating the superficial layer, the deep plane facelift releases the underlying structures underneath, enabling doctors to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing tension 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 comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking 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 cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

If injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Research have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the reality that in a sense, the face becomes slightly waterlogged because its capacity to drain bodily fluid has been reduced.” Though research into the area is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been issued, and further research announced. One highly regarded face specialist, commenting anonymously, says he would avoid using fillers in a patient because of the dangers they pose. “Many surgeons don’t want to talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a face and neck lift could be what she needed to exit the cycle of treatments. After 24 months, she found herself selecting from a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her doctor recommended that a facial lift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The day before her operation, 24 hours post she’d touched down alone in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some cheek fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|