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

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. Not for the usual reasons associated with a house full of clamorous preteen kids, but since it’s the first time she will showcase her new face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I appear,’” states the 30-year-old property agent from south Florida.

How she looks is, well, a somewhat startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of people electing to have a facelift in their twenties and thirties – well over a ten years before typical surgeons’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are structured a little like onion layers,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and drags the skin down with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and causes looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of new, famous-figure-promoted operative methods are attracting a new kind of customer towards this major operation. Statistics indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are asking now to appear as the best version 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 reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy entails lifting the superficial layer, the deep plane facelift releases the underlying structures beneath it, enabling doctors to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and more durable outcome. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look young,” she says. “I did it because the filler harmed my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

If injectable substances completely disappear has historically been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is also the reality that to some extent, the face gets slightly waterlogged because its capacity to remove bodily fluid has been reduced.” Though studies into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using injectables in a patient because of the risks they present. “A lot of surgeons don’t want to discussing this, because the companies who produce injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a list of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her doctor advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her surgery, one day after she’d touched down solo in the country, she opted to include a lip lift. “Then he said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|