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

Onemanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. Not for the typical causes associated with a house full of clamorous adolescent kids, but because it’s the first time she will debut her recently altered face to friends and relatives. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not the way I look,’” states the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a little startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – look is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals choosing to have a facelift in their 20s and 30s – well over a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a facelift, lifts the ligaments in the face that start to sag as we grow older. “Our faces are structured a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and drags the dermis downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and causes laxity in the skin – alongside the common adoption of slimming medications, cut-price medical tourism, and the advancement of new, celebrity-endorsed surgical techniques are driving a new kind of customer towards this major operation. Reports show an 8% increase in facelifts over the past 12 months in the UK; while a study found that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for individuals aged 35-55.

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

Deep Plane Technique

While a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift releases the underlying structures beneath it, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Elevating the whole facial structure as a single unit allows for a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the injectable harmed my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be where I’m at currently.”

If dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the fact that to some extent, the face becomes slightly waterlogged because its ability to drain lymphatic fluid has been diminished.” Though research into the area is preliminary, cautionary statements 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 avoid using injectables in a client because of the risks they pose. “A lot of doctors don’t want to talk about this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue adding more – 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 facial and neck surgery could be what she needed to finally step off the cycle of treatments. After 24 months, she ended up selecting from a list of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor 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 jawline surgery. The day before her operation, one day after she’d touched down alone in the country, she opted to include a lip lift. “Then he said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|