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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. Not for the usual reasons related to a home packed of loud preteen children, but since it’s the initial occasion she will showcase her recently altered face to acquaintances and extended family. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not the way I look,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their twenties and thirties – significantly before a ten years before typical surgeons’ usual candidate age 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 former NHS consultant 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.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Our faces are built a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what ages us; that’s what loosens and sags and drags the dermis down with it.”

You risk operating on individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and causes laxity in the dermis – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of new, famous-figure-promoted operative methods are attracting a new kind of customer towards this invasive surgery. Statistics show an 8% increase in facial lifts over the past 12 months in the UK; while a study found that the portion of youthful candidates is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are now requesting to appear as the best version of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails elevating the SMAS, the comprehensive lift loosens the facial ligaments underneath, enabling doctors to restructure the face by moving the underlying layers, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting outcome. It additionally implies that the surgery is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I underwent it because the filler harmed my face. I regret ever done it. If I had avoided the filler, I don’t think I would be in this situation right now.”

Whether dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘pillow face’ is additionally the fact that in a sense, the face becomes slightly waterlogged because its capacity to drain bodily fluid has been diminished.” Although research into the area is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies announced. One highly regarded face specialist, speaking on the condition of anonymity, says he would avoid using injectables in a patient because of the dangers they present. “Many surgeons avoid talk about this, because the companies who produce filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep adding more – especially as it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift could be what she needed to exit the cycle of treatments. After 24 months, she ended up choosing between a list of recommended hotels in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the laxity she was finding in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d touched down solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|