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

Onemanda Preisinger feels anxious about her child’s upcoming 13th birthday party. Not for the usual causes associated with a home packed of loud adolescent kids, but since it’s the first time she will showcase her new face to acquaintances and extended family. “Obviously 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 property agent from Southern Florida.

Her appearance is, admittedly, a somewhat surprising – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the outcome of six cosmetic procedures, including an minimally invasive facelift, performed by a surgeon 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 unseal my eyes. That’s how swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals choosing to have a rhytidectomy in their 20s and 30s – well over a decade prior to most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are built a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that is what causes aging; that’s what becomes lax and pulls the dermis downward with it.”

You risk performing surgery on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and leads to looseness in the skin – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the development of new, famous-figure-promoted operative methods are attracting a new kind of patient towards this invasive surgery. Reports show an 8% increase in facelifts over the past 12 months in the UK; while a survey found that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on patients aged 35-55.

“People are asking now to appear as the optimal form of themselves and naturally the techniques are following,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves elevating the SMAS, the deep plane facelift releases the facial ligaments beneath it, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the tight, stretched appearance occasionally caused by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” explains 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 passenger.” Elevating the whole facial structure as a single unit allows for a more natural-looking and longer-lasting result. It also means that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied 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 underwent it because the injectable harmed my face. I regret ever done it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”

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 completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets somewhat fluid-filled because its ability to remove lymphatic fluid has been reduced.” Although research into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and further research announced. An esteemed face specialist, commenting anonymously, says he would never use injectables in a client because of the risks they present. “A lot of doctors avoid talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – especially as it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she required to exit the injectable hamster wheel. After 24 months, she found herself choosing between a list of recommended hotels in the city, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her doctor advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The day before her surgery, 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.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|