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

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. Not for the typical causes related to a home packed of loud adolescent kids, but since it’s the initial occasion she will reveal her new face to acquaintances and relatives. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not the way I look,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My spouse became emotional when he viewed me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ typical patient age range of forty to sixty. (Although most surgeons are eager to highlight the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Our faces are structured a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and pulls the skin downward with it.”

You risk operating on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and causes laxity in the dermis – combined with the widespread use of slimming medications, cut-price medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are attracting a new kind of customer towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the last year in the UK; while a study revealed that the portion of younger facelift patients is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are now requesting to look like the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails lifting the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, allowing doctors to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the age of 30. But long-term using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the filler harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

If injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the reality that in a sense, the face becomes somewhat waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though studies into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies initiated. One highly regarded face specialist, commenting anonymously, says he would avoid using injectables in a patient because of the risks they present. “A lot of surgeons avoid talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue adding more – particularly when it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a face and neck lift might be what she required to exit the injectable hamster wheel. Two years later, she found herself selecting from a selection of recommended hotels in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facelift was the right solution for the looseness she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in Turkey, she opted to include a lip lift. “Then he said, ‘We will elevate the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|