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

Onemanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. It’s not due to the usual causes associated with a house full of loud adolescent kids, but since it’s the initial occasion she will debut her new face to friends and extended family. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I look,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My spouse teared up 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: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is among a growing number of individuals electing to undergo a facelift in their 20s and 30s – well over a decade prior to typical surgeons’ typical patient age range of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds requesting facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the tissues in the face that start to sag as we grow older. “Our faces are structured a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that is what causes aging; that is what becomes lax and drags the dermis downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and causes laxity in the skin – alongside the common adoption of slimming medications, low-cost medical tourism, and the development of novel, famous-figure-promoted operative methods are attracting a different type of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a study found that the portion of youthful candidates is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, enabling doctors to reshape the face by moving the underlying layers, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London 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.” Lifting the whole facial structure as a unified block allows for a more natural-looking and longer-lasting outcome. It additionally implies that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I underwent it because the filler ruined my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

Whether injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Studies have indicated that they seldom fully dissipate,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is additionally the fact that to some extent, the face gets slightly waterlogged because its ability to drain lymphatic fluid has been reduced.” Though research into the area is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been released, and further research initiated. An esteemed facial plastic surgeon, commenting anonymously, says he would avoid using injectables in a patient because of the dangers they present. “A lot of doctors don’t want to discussing this, because the companies who produce filler can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she had to keep adding more – especially as it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she needed to finally step off the cycle of treatments. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her doctor advised her that a facelift was the right solution for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d arrived solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|