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

Onemanda Preisinger feels anxious about her child’s upcoming 13th birthday party. Not for the typical causes related to a house full of loud adolescent kids, but since it’s the first time she will reveal her new face to acquaintances and relatives. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not the way I look,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – look is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a rising count of individuals choosing to undergo a rhytidectomy in their 20s and 30s – well over a decade before most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major surgery, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the ligaments 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 facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and pulls the skin down with it.”

You risk operating on individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and causes looseness in the dermis – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the development of new, celebrity-endorsed operative methods are attracting a new kind of patient towards this invasive surgery. Statistics show an eight percent rise in facelifts over the last year in the United Kingdom; while a survey found that the portion of youthful candidates is growing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are now requesting to look like the best version of themselves and obviously the methods are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails elevating the superficial layer, the deep plane facelift releases the facial ligaments beneath it, enabling surgeons to restructure the face by moving the underlying layers, and preventing the tight, stretched appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and longer-lasting outcome. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at least not at the thirty years old. But long-term using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent it because the filler ruined my face. I wish I had never using it. If I didn’t have the filler, I don’t think I would be where I’m at currently.”

If injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘pillow face’ is additionally the fact that in a sense, the face gets slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Though research into the area is preliminary, warnings on injectables’ possible effects on the body’s drainage have been released, and additional studies announced. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would never use injectables in a client because of the dangers they present. “A lot of doctors avoid discussing this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep adding more – particularly when it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she required to exit the cycle of treatments. After 24 months, she found herself 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 scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her surgery, one day after she’d touched down alone in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|