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

Onemanda Preisinger feels anxious about her daughter’s impending 13th birthday party. Not for the usual causes associated with a house full of clamorous adolescent children, but because it’s the first time she will reveal her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they come in, ‘Just so you know, this is not the way I appear,’” says the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My spouse teared up when he saw me for the first time because I wasn’t able to even open my eyes. That indicates swollen I was,” she explains to me via online call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a growing number of people choosing to have a facelift in their 20s and 30s – significantly before a ten years before most doctors’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that begin to droop as we grow older. “Our faces are structured a little like onion layers,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and drags the dermis down with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of dermal fillers stretches the face and causes laxity in the skin – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a different type of customer towards this major operation. Reports show an 8% increase in facial lifts over the last year in the United Kingdom; while a study revealed that the portion of younger facelift patients is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and naturally the methods are following,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy involves elevating the SMAS, the deep plane facelift loosens the underlying structures beneath it, enabling surgeons to reshape the face by moving the underlying layers, and preventing the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and longer-lasting outcome. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the injectable ruined my face. I wish I had never using it. If I didn’t have the filler, I don’t think 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. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘pillow face’ is also the fact that in a sense, the face gets somewhat waterlogged because its ability to remove bodily fluid has been reduced.” Although studies into the topic is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the dangers they pose. “A lot of doctors avoid talk about this, because the companies who produce filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue adding more – especially as it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she required to exit the injectable hamster wheel. After 24 months, 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.

Initially, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon advised her that a facelift was the correct option for the looseness she was finding in her face. She arranged a brow lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d arrived solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|