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

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday party. It’s not due to the usual reasons related to a house full of clamorous preteen kids, but because it’s the initial occasion she will debut her new face to friends and extended family. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of individuals choosing to undergo a facelift in their twenties and thirties – significantly before a decade prior to most doctors’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a bit concerned when I observe individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Human faces are structured a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and pulls the skin downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and causes looseness in the dermis – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are attracting a new kind of customer towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the past 12 months in the UK; while a survey revealed that the portion of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are now requesting to look like the optimal form of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails elevating the SMAS, the deep plane facelift releases the facial ligaments underneath, allowing surgeons to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Elevating the whole facial structure as a unified block results in a more natural-looking and more durable outcome. It also means 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 “beautification” and facial restructuring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – 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 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she says. “I did it because the filler harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

If dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” says Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the reality that to some extent, the face gets slightly fluid-filled because its ability to remove bodily fluid has been reduced.” Although studies into the area is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and further research announced. An esteemed face specialist, commenting on the condition of anonymity, says he would never use injectables in a client because of the risks they present. “Many surgeons don’t want to talk about this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she had to keep replenishing it – especially as it began moving to other parts 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 injectable hamster wheel. Two years later, she found herself choosing between a selection of recommended hotels in the city, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facial lift was the right solution 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, one day after she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|