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

Onemanda Preisinger feels anxious about her child’s impending 13th birthday party. Not for the usual causes associated with a house full of loud adolescent children, but because it’s the first time she will showcase her recently altered face to acquaintances and relatives. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I appear,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My spouse became emotional when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how swollen I was,” she tells me via online call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals electing to have a facelift in their 20s and 30s – well over a decade before most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Our faces are built a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that is what ages us; that is what becomes lax and drags the skin downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to laxity in the dermis – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed operative methods are attracting a different type of patient towards this major operation. Reports show an 8% increase in facelifts over the last year in the UK; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“Patients are now requesting to look like the optimal form of themselves and obviously the techniques are following,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails lifting the superficial layer, the comprehensive lift releases the facial ligaments underneath, allowing surgeons to reshape the face by repositioning the underlying layers, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing stress on the skin 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 deeper tissue that is repositioned. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a authentic-appearing and longer-lasting outcome. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the injectable ruined my face. I wish I had never done it. If I had avoided 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 aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” says Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we call ‘pillow face’ is additionally the reality that to some extent, the face becomes slightly fluid-filled because its ability to remove bodily fluid has been reduced.” Though research into the area is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and additional studies initiated. An esteemed face specialist, speaking anonymously, mentioned he would avoid using injectables in a patient because of the dangers they pose. “Many doctors avoid discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she required to exit the cycle of treatments. Two years later, she ended up selecting from a selection of suggested accommodations in the city, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d touched down alone in the country, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|