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

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. Not for the usual reasons related to a house full of clamorous adolescent children, but because it’s the initial occasion she will debut her new face to friends and relatives. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not the way I look,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, temporary – appearance is the result of six cosmetic procedures, such as an endoscopic mid-facelift, conducted 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 open my eyes. That’s how puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a rising count of individuals electing to have a facelift in their 20s and 30s – well over a ten years before most doctors’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are built a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and drags the skin downward with it.”

You risk operating on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels expands the face and causes looseness in the skin – combined with the widespread use of slimming medications, cut-price surgical travel, and the advancement of new, celebrity-endorsed operative methods are driving a different type of patient towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a survey found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and naturally the methods are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves elevating the superficial layer, the comprehensive lift releases the underlying structures beneath it, enabling doctors to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, 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 dermis comes with it as a secondary element.” Elevating the whole facial structure as a single unit allows for 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 rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I did it because the filler harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

Whether injectable substances completely disappear has long been a point of contention in the cosmetic field. “Studies have shown that they seldom completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the reality that in a sense, the face becomes slightly waterlogged because its capacity to remove lymphatic fluid has been diminished.” Although studies into the area is early-stage, warnings on injectables’ possible effects on the body’s drainage have been released, and further research initiated. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would avoid using injectables in a patient because of the risks they present. “Many doctors avoid talk about this, because the companies who produce injectables can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – especially as it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a face and neck lift could be what she needed to exit the cycle of treatments. After 24 months, she found herself choosing between a selection of suggested accommodations in the city, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor advised her that a facelift was the correct option for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d touched down solo in the country, she decided to add a mouth enhancement. “Then he said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|