‘My Eyes Were So Puffy I Was Unable to Even Unseal Them’

Onemanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the typical causes related to a house full of clamorous adolescent kids, but because it’s the first time she will reveal her recently altered face to friends and extended family. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-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 industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, 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 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.’”

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 – well over a ten years before most doctors’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Our faces are structured a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that is what loosens and sags and pulls the skin down with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to looseness in the dermis – alongside the widespread use of slimming medications, cut-price medical tourism, and the advancement of new, celebrity-endorsed operative methods are attracting a new kind of patient towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a survey found that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the superficial layer, the deep plane facelift loosens the underlying structures beneath it, allowing surgeons to restructure the face by moving the deeper tissue, and preventing the taut, pulled look sometimes wrought by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a single unit results in a authentic-appearing and more durable outcome. It also means that the procedure is not just being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But long-term using injectable gels 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 desired to appear 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 think I would be where I’m at right now.”

If injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Research have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is also the fact that to some extent, the face gets slightly waterlogged because its capacity to remove bodily fluid has been diminished.” Though studies into the area is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies announced. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using fillers in a patient because of the risks they pose. “Many doctors don’t want to talk about this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state proposed that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a selection of recommended hotels in the city, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her surgery, one day after she’d touched down solo in Turkey, she opted to include a lip lift. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt 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|