‘My Eyes Were So Puffy I Couldn’t Even Open 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 clamorous preteen kids, but since it’s the first time she will debut her recently altered face to friends and relatives. “Obviously I’m going to inform everyone as they come in, ‘Just so you know, this is not the way I look,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My spouse became emotional when he saw me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a growing number of individuals choosing to have a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ typical patient age range of 40 to 60. (Although 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,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, also known as a facelift, elevates the tissues in the face that begin to droop as we age. “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 known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and pulls the skin downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and causes looseness in the skin – combined with the common adoption of slimming medications, cut-price medical tourism, and the advancement of new, famous-figure-promoted operative methods are driving a different type of patient towards this major operation. Reports show an eight percent rise in facial lifts over the last year in the UK; 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 optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift entails lifting the SMAS, the comprehensive lift loosens the facial ligaments beneath it, allowing surgeons to reshape the face by repositioning the underlying layers, and preventing the taut, pulled appearance occasionally caused by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting outcome. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the filler ruined my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

If dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can block 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 remove lymphatic fluid has been diminished.” Although studies into the topic is early-stage, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would avoid using fillers in a client because of the risks they pose. “Many surgeons don’t want to discussing this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facelift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d arrived solo in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|