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

Onemanda Preisinger is nervous about her child’s impending 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 recently altered face to friends and extended family. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not how I look,’” says the 30-year-old property agent from south Florida.

How she looks is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That indicates swollen I was,” she tells 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 Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of people electing to undergo a facelift in their twenties and thirties – significantly before a decade prior to most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds asking for facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Human faces are structured a little like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that is what ages us; that’s what becomes lax and pulls the dermis downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to laxity in the skin – alongside the common adoption of slimming medications, low-cost medical tourism, and the development of new, celebrity-endorsed operative methods are driving a new kind of patient towards this major operation. Statistics indicate an 8% increase in facelifts over the past 12 months in the UK; while a study revealed that the portion of younger facelift patients is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the underlying structures beneath it, allowing doctors to restructure the face by repositioning the underlying layers, and preventing the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Lifting the whole facial structure as a single unit allows for a more natural-looking and more durable result. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” she says. “I did it because the filler harmed my face. I wish I had never using it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”

If injectable substances ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have shown that they seldom completely dissolve,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is also the reality that in a sense, the face gets slightly waterlogged because its ability to drain lymphatic fluid has been reduced.” Although studies into the area is early-stage, warnings on injectables’ potential impact on the lymphatic system have been released, and further research initiated. One highly regarded face specialist, speaking anonymously, says he would never use injectables in a client because of the risks they pose. “Many surgeons avoid discussing this, because the companies who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – particularly when it started to migrate 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 exit the injectable hamster wheel. Two years later, she found herself choosing between a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

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 correct option for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|