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

Onemanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the usual causes associated with a home packed of clamorous adolescent kids, but since it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of half a dozen aesthetic surgeries, including an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she explains to me via online call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – significantly before a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see people opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Our faces are built a little like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue known as the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and drags the dermis down with it.”

You endanger performing surgery on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and causes laxity in the dermis – combined with the widespread use of slimming medications, low-cost medical tourism, and the advancement of novel, celebrity-endorsed surgical techniques are driving a different type of patient towards this major operation. Reports indicate an 8% increase in facelifts over the past 12 months in the UK; while a study found that the percentage of youthful candidates is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the best version of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves lifting the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, enabling doctors to restructure the face by moving the deeper tissue, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting result. It additionally implies that the surgery is not just being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I did 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 in this situation currently.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the fact that to some extent, the face gets slightly waterlogged because its capacity to remove bodily fluid has been diminished.” Although research into the area is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and further research announced. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would avoid using injectables in a client because of the risks they pose. “Many surgeons don’t want to discussing this, because the companies who produce filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she needed to exit the cycle of treatments. Two years later, she found herself selecting from a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|