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

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. Not for the usual reasons related to a home packed of loud adolescent children, but because it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Clearly I’m going to inform everyone as they arrive, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the result of six cosmetic procedures, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, last month. “My spouse teared up when he saw me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of people choosing to have a rhytidectomy in their twenties and thirties – significantly before a decade before most doctors’ 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 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Human faces are built a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and pulls the skin down with it.”

You risk operating on people that have deeper issues. 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 expands the face and leads to laxity in the dermis – alongside the common adoption of slimming medications, cut-price surgical travel, and the advancement of new, famous-figure-promoted surgical techniques are driving a new kind of patient towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study found that the portion of youthful candidates is growing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift entails elevating the SMAS, the deep plane facelift releases the underlying structures underneath, allowing doctors to reshape the face by moving the underlying layers, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and more durable result. It additionally implies that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the thirty years old. But long-term using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I did it because the injectable harmed my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be where I’m at right now.”

Whether dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the reality that to some extent, the face becomes somewhat waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though studies into the topic is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and additional studies announced. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would never use fillers in a client because of the dangers they present. “Many doctors avoid discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift might be what she required to finally step off the cycle of treatments. Two years later, she ended up selecting from a selection of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facelift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d touched down alone in Turkey, she decided to add a lip lift. “Then he said, ‘We will lift the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She spent $22,000 (£16,500) for the half-day operation, including a three-day|