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

Onemanda Preisinger is nervous about her daughter’s impending 13th birthday party. It’s not due to the typical causes related to a house full of loud adolescent kids, but since it’s the initial occasion she will showcase her new face to friends and extended family. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I appear,’” states the thirty-year-old real estate agent from south Florida.

How she looks is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of individuals electing to undergo a facelift in their 20s and 30s – well over a ten years before typical surgeons’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on 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.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we grow older. “Human faces are built a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that is what causes aging; that is what loosens and sags and pulls the dermis down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and causes looseness in the skin – alongside the common adoption of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are attracting a different type of customer towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are asking now to look like the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, allowing doctors to restructure the face by moving the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the injectable harmed my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies 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 term ‘pillow face’ is additionally the reality that to some extent, the face becomes slightly fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though research into the area is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been issued, and further research announced. One highly regarded face specialist, commenting anonymously, mentioned he would never use injectables in a client because of the dangers they pose. “A lot of doctors don’t want to discussing this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a face and neck lift could be what she needed to exit the injectable hamster wheel. Two years later, she found herself selecting from a selection of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d arrived solo in the country, she opted to include a mouth enhancement. “Then he said, ‘We will lift the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|