‘My Eyes Were So Swollen I Was Unable to Even Unseal Them’

Onemanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical reasons related to a house full of clamorous adolescent children, but because it’s the initial occasion she will showcase her recently altered face to acquaintances and extended family. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not the way I appear,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via online call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals choosing to have a facelift in their twenties and thirties – well over a decade prior to most doctors’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major surgery, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are built a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and pulls the dermis down with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and causes laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the development of new, famous-figure-promoted operative methods are attracting a different type of patient towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the past 12 months in the UK; while a study found that the percentage of youthful candidates is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and naturally the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy entails lifting the SMAS, the comprehensive lift releases the facial ligaments underneath, enabling doctors to restructure the face by moving the deeper tissue, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” explains 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 secondary element.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting 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 describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the filler harmed 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 ever fully dissolve has historically been a point of contention in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” says Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its ability to remove lymphatic fluid has been reduced.” Although studies into the topic is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies announced. An esteemed face specialist, commenting anonymously, mentioned he would avoid using injectables in a patient because of the risks they pose. “Many doctors don’t want to talk about this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started 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 suggested that a face and neck lift might be what she required to exit the cycle of treatments. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down alone in the country, she decided to add a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|