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

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. It’s not due to the usual reasons associated with a house full of clamorous preteen children, but since it’s the initial occasion she will reveal her recently altered face to friends and extended family. “Clearly I’m going to tell everyone as they arrive, ‘For your information, this is not the way I look,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – look is the result of half a dozen cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even open my eyes. That indicates swollen I was,” she explains to me via online call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of people choosing to undergo a facelift in their 20s and 30s – significantly before a decade before most doctors’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a facelift, lifts the ligaments in the face that begin to droop as we age. “Human 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 connective tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that is what causes aging; that is what becomes lax and drags the skin down with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and leads to looseness in the skin – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are driving a different type of patient towards this major operation. Statistics show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the portion of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“People are asking now to look like the best version of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift entails elevating the SMAS, the comprehensive lift releases the facial ligaments underneath, allowing doctors to restructure the face by moving the deeper tissue, and preventing the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue 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 additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But years of using injectable gels in an effort at “facial balancing” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she says. “I underwent it because the filler ruined my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be in this situation right now.”

If injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Research have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the reality that to some extent, the face becomes slightly fluid-filled because its ability to remove lymphatic fluid has been reduced.” Although studies into the topic is early-stage, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, commenting anonymously, says he would never use injectables in a patient because of the risks they pose. “A lot of surgeons don’t want to discussing this, because the companies who make filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a face and neck lift could be what she required to finally step off the cycle of treatments. Two years later, she found herself choosing between a list of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor recommended that a facelift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a neck lift. The day before her surgery, 24 hours post she’d arrived alone in Turkey, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|