‘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 home packed of clamorous preteen kids, but since it’s the initial occasion she will debut her new face to friends and extended family. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I look,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – look is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My spouse teared up when he saw me for the first time because I couldn’t even unseal my eyes. That indicates swollen I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of individuals electing to undergo a rhytidectomy in their 20s and 30s – significantly before a ten years before most doctors’ typical patient age range of 40 to 60. (Though most surgeons are eager to highlight the industry edict of: “We address heredity, not age.”) “I have 28-year-olds asking for facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major surgery, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Human faces are structured a bit like onion layers,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and pulls the skin downward with it.”

You endanger performing surgery on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when overuse of dermal fillers expands the face and causes looseness in the dermis – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a new kind of patient towards this major operation. Reports show an 8% increase in facial lifts over the last year in the United Kingdom; while a survey found that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are asking now to look like the best version of themselves and obviously the techniques are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves lifting the SMAS, the deep plane facelift releases the underlying structures beneath it, allowing doctors to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and more durable result. It also means that the surgery is not just being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort 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 youthful,” she clarifies. “I did it because the filler harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

If dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the fact that to some extent, the face gets somewhat fluid-filled because its capacity to drain lymphatic fluid has been diminished.” Although research into the area is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies initiated. One highly regarded face specialist, commenting on the condition of anonymity, says he would never use fillers in a patient because of the risks they pose. “A lot of doctors avoid discussing this, because the companies who make filler can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – especially as it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested 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 suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor recommended that a facelift was the correct option for the laxity she was experiencing in her face. She booked 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 mouth enhancement. “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.’ So I ended up including additional procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|