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

Onemanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual reasons related to a house full of clamorous adolescent children, but because it’s the first time she will reveal her new face to acquaintances and extended family. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of half a dozen aesthetic surgeries, such as an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My spouse became emotional when he saw me for the initial time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a rising count of people choosing to undergo a rhytidectomy in their twenties and thirties – significantly before a ten years before typical surgeons’ typical patient age range of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We address genetics, not age.”) “I have 28-year-olds requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are structured a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and drags the skin downward with it.”

You risk performing surgery on people that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and causes laxity in the skin – alongside the widespread use of weight-loss drugs, low-cost surgical travel, and the development of new, famous-figure-promoted surgical techniques are driving a different type of customer towards this major operation. Statistics indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a study revealed that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are asking now to look like the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift entails elevating the superficial layer, the deep plane facelift releases the facial ligaments beneath it, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis comes with it as a passenger.” Lifting the whole facial structure as a unified block results in a more natural-looking and longer-lasting outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the thirty years old. But long-term using injectable gels in an effort at “facial balancing” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I did it because the filler ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has long been a debated topic 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. A contributing factor to what we call ‘pillow face’ is also the reality that to some extent, the face becomes slightly fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Although research into the area is early-stage, warnings on injectables’ potential impact on the lymphatic system have been released, and further research announced. One highly regarded face specialist, commenting anonymously, mentioned he would never use injectables in a patient because of the dangers they present. “A lot of doctors don’t want to talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she had to keep adding more – particularly when it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a selection of suggested accommodations in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facelift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d arrived solo in Turkey, she decided to add a lip lift. “Then he stated, ‘We will elevate the under-eye bags.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|