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

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday party. It’s not due to the typical causes related to a house full of clamorous adolescent children, but because it’s the initial occasion she will debut her new face to friends and relatives. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not how I appear,’” states the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – look is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. 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 have a facelift in their 20s and 30s – well over a ten years prior to typical surgeons’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” says based in London 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 somewhat worried when I observe people opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “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 layer of connective tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and pulls the dermis down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and causes laxity in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a different type of customer towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are asking now to appear as the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a method promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails elevating the SMAS, the comprehensive lift loosens the underlying structures beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched look sometimes wrought by older methods. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking 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 aesthetics industry describes it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the injectable ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Research have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the reality that in a sense, the face becomes somewhat fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though research into the area is early-stage, cautionary statements on injectables’ possible effects on the body’s drainage have been released, and further research initiated. An esteemed face specialist, speaking on the condition of anonymity, says he would never use injectables in a client because of the dangers they present. “Many doctors don’t want to talk about this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she had to keep adding more – especially as it began moving to different areas of her face. She was just 28 when a local plastic surgeon in the state suggested that a facial and neck surgery 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 Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon recommended that a facial lift was the right solution for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|