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

Onemanda Preisinger feels anxious about her daughter’s impending 13th birthday party. It’s not due to the typical reasons related to a home packed of loud adolescent children, but because it’s the first time she will reveal her new face to acquaintances and relatives. “Obviously I’m going to tell all guests as they arrive, ‘For your information, this is not how I look,’” says the 30-year-old property agent from Southern Florida.

How she looks is, well, a little startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – look is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she explains to 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 jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of people electing to undergo a rhytidectomy in their 20s and 30s – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Our faces are structured a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and drags the skin downward with it.”

You risk performing surgery on people that have underlying problems. It’s not a practice for an conscientious surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and leads to looseness in the dermis – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, celebrity-endorsed operative methods are driving a new kind of patient towards this major operation. Statistics show an eight percent rise in facelifts over the past 12 months in the UK; while a study found that the percentage of youthful candidates is growing, with one-third of procedures now conducted for patients aged 35-55.

“People are asking now to look like the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy entails lifting the superficial layer, the deep plane facelift loosens the underlying structures underneath, enabling doctors to restructure the face by moving the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable outcome. It additionally implies that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the thirty years old. But long-term using injectable gels in an effort at “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I did it because the injectable ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t believe I would be in this situation right now.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have shown that they seldom fully dissipate,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the reality that to some extent, the face becomes slightly waterlogged because its capacity to remove lymphatic fluid has been reduced.” Although studies into the topic is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies announced. One highly regarded face specialist, commenting anonymously, mentioned he would never use injectables in a patient because of the dangers they present. “Many surgeons don’t want to talk about this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a list of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon advised her that a facelift was the right solution 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 surgery, 24 hours post she’d touched down alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she says. She spent $22,000 (£16,500) for the half-day operation, including a three-day|