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

Onemanda Preisinger feels anxious about her child’s impending 13th birthday celebration. It’s not due to the usual causes associated with a house full of clamorous adolescent children, but since it’s the initial occasion she will debut her new face to friends and relatives. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not the way I appear,’” says the 30-year-old property agent from south Florida.

How she looks is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon 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 needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a growing number of people choosing to have a rhytidectomy in their twenties and thirties – well over a ten years prior to most doctors’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I see people choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are built a little like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that is what causes aging; that is what loosens and sags and pulls the skin down with it.”

You risk operating on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and leads to looseness in the dermis – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a different type of customer towards this invasive surgery. Reports show an 8% increase in facelifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and naturally the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails elevating the SMAS, the comprehensive lift releases the facial ligaments beneath it, enabling surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The dermis follows along as a passenger.” Elevating the whole facial structure as a single unit allows for a more natural-looking and more durable outcome. It additionally implies that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at least not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear young,” she clarifies. “I did it because the filler 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 right now.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though research into the topic is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use injectables in a patient because of the dangers they pose. “A lot of surgeons don’t want to talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – especially as it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she required to finally step off the cycle of treatments. After 24 months, she ended up selecting from a list of recommended hotels in Istanbul, texted 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 surgeon advised her that a facelift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d arrived solo in the country, she opted to include a lip lift. “Then he said, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|