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

Onemanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual reasons related to a house full of loud adolescent children, but because it’s the first time she will debut her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of individuals choosing to undergo a facelift in their 20s and 30s – well over a ten years prior to typical surgeons’ typical patient age range of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “Human faces are built a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and drags the dermis downward with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to looseness in the dermis – alongside the common adoption of slimming medications, low-cost surgical travel, and the advancement of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this invasive surgery. Reports show an eight percent rise in facelifts over the last year in the UK; while a survey revealed that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails elevating the SMAS, the comprehensive lift loosens the underlying structures beneath it, allowing surgeons to restructure the face by repositioning the deeper tissue, and preventing the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin follows along as a passenger.” Lifting the whole facial structure as a single unit allows for a more natural-looking and longer-lasting result. It additionally implies that the surgery 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’re getting numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler ruined my face. I wish I had never using it. If I had avoided the filler, I don’t believe I would be in this situation right now.”

If dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the fact that to some extent, the face becomes somewhat fluid-filled because its ability to remove bodily fluid has been reduced.” Although research into the area is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and further research announced. An esteemed face specialist, speaking on the condition of anonymity, says he would never use fillers in a client because of the risks they pose. “Many doctors avoid discussing this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – particularly when it began moving to different areas 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 needed to exit the cycle of treatments. After 24 months, she found herself choosing between a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her surgeon advised her that a facelift was the correct option for the looseness 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 alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|