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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the usual reasons associated with a house full of loud adolescent kids, but since it’s the initial occasion she will debut her new face to acquaintances and relatives. “Obviously I’m going to tell everyone as they arrive, ‘For your information, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the result of six cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she explains to 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 jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of people choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as 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,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and pulls the dermis downward with it.”

You endanger performing surgery on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and causes looseness in the skin – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the development of new, famous-figure-promoted operative methods are attracting a different type of customer towards this invasive surgery. Statistics show an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a survey found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged 35-55.

“People are asking now to look like the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves elevating the SMAS, the deep plane facelift loosens the facial ligaments beneath it, allowing doctors to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and more durable result. It also means that the surgery 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 patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the filler harmed my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

Whether injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Research have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘pillow face’ is additionally the reality that in a sense, the face becomes somewhat fluid-filled because its ability to remove bodily fluid has been diminished.” Although research into the topic is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and further research announced. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would never use fillers in a client because of the dangers they pose. “A lot of surgeons avoid talk about this, because the companies who make filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – particularly when it began moving 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 injectable hamster wheel. After 24 months, she ended up selecting from a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facial lift was the correct option for the looseness she was finding 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 touched down solo in Turkey, she decided to add a lip lift. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some cheek fat, it will contour your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|