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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual causes related to a house full of clamorous adolescent kids, but since it’s the first time she will debut her recently altered face to acquaintances and relatives. “Obviously I’m going to tell all guests as they arrive, ‘For your information, this is not the way I look,’” states the thirty-year-old real estate agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband 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 explains to me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a growing number of individuals electing to undergo a facelift in their 20s and 30s – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have 28-year-olds asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “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 layer of connective tissue called the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and drags the skin downward with it.”

You risk operating 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 causes looseness in the skin – alongside the widespread use of slimming medications, cut-price surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are driving a different type of patient towards this major operation. Reports indicate an eight percent rise in facelifts over the past 12 months in the UK; while a study revealed that the portion of youthful candidates is growing, with one-third of procedures now conducted for patients aged 35-55.

“People are asking now to look like the best version of themselves and naturally the techniques are following,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift involves elevating the superficial layer, the comprehensive lift loosens the facial ligaments underneath, allowing surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled appearance occasionally caused by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Elevating the whole facial structure as a unified block results in a authentic-appearing and more durable outcome. It additionally implies that the procedure is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the filler harmed my face. I wish I had never using it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”

Whether injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” 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 waterlogged because its ability to remove lymphatic fluid has been reduced.” Although studies into the area is preliminary, warnings on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, speaking anonymously, mentioned he would never use injectables in a client because of the dangers they pose. “A lot of surgeons avoid talk about this, because the manufacturers who produce filler can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a face and neck lift could be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a selection of suggested accommodations in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the right solution for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, 24 hours post she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|