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

Onemanda Preisinger is nervous about her daughter’s impending 13th birthday party. It’s not due to the usual causes related to a house full of loud preteen children, but since it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not how I appear,’” says the 30-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – appearance is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even unseal my eyes. That indicates swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals choosing to have a facelift in their 20s and 30s – well over a decade before typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” states based in London 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 observe individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that start to sag as we age. “Our faces are built a bit like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and drags the skin downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and leads to looseness in the dermis – combined with the common adoption of slimming medications, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are attracting 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 survey revealed that the portion of youthful candidates is growing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails elevating the SMAS, the deep plane facelift releases the underlying structures underneath, enabling surgeons to restructure the face by moving the underlying layers, and preventing the tight, stretched look sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I did it because the filler ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be where I’m at currently.”

If injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have shown that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is additionally the fact that in a sense, the face gets slightly waterlogged because its capacity to drain bodily fluid has been diminished.” Though studies into the area is preliminary, warnings on injectables’ potential impact on the lymphatic system have been released, and additional studies announced. An esteemed facial plastic surgeon, commenting anonymously, says he would avoid using injectables in a patient because of the risks they pose. “Many doctors avoid talk about this, because the manufacturers who produce injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she had to keep adding more – especially as it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. After 24 months, she ended up choosing between a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon advised her that a facelift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her surgery, one day after she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|