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

Onemanda Preisinger experiences worry about her child’s upcoming 13th birthday party. It’s not due to the typical causes associated with a home packed of loud adolescent children, but because it’s the first time she will showcase her recently altered face to friends and relatives. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not the way I appear,’” states the thirty-year-old property agent from south Florida.

Her appearance is, well, a little surprising – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – appearance is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals choosing to have a rhytidectomy in their 20s and 30s – well over a ten years before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Human faces are structured a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what causes aging; that’s what becomes lax and pulls the skin downward with it.”

You risk performing surgery on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and causes laxity in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of new, celebrity-endorsed operative methods are driving a different type of customer towards this major operation. Reports show an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of youthful candidates is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted 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 loosens the underlying structures underneath, allowing doctors to reshape the face by moving the deeper tissue, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The skin follows along as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting result. It also means that the surgery is not just being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But long-term using injectable gels 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 wanted to look youthful,” she says. “I did it because the filler ruined my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

If dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face becomes somewhat waterlogged because its ability to drain lymphatic fluid has been reduced.” Although studies into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been released, and further research announced. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using fillers in a patient because of the dangers they present. “Many surgeons avoid discussing this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d touched down alone in Turkey, she opted to include a lip lift. “Then he stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|