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

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. Not for the usual reasons related to a house full of loud preteen kids, but since it’s the initial occasion she will debut her new face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘For your information, 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 held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to have a facelift in their twenties and thirties – significantly before a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major procedure, and I’m a somewhat worried when I see individuals opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop 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 top, then a stratum of supportive tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what causes aging; that is what becomes lax and pulls the skin down with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and leads to looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a new kind of customer towards this invasive surgery. Statistics show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the percentage of youthful candidates is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves lifting the superficial layer, the comprehensive lift releases the facial ligaments beneath it, allowing surgeons to restructure the face by moving the underlying layers, and avoiding the tight, stretched appearance occasionally caused by older methods. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable outcome. It additionally implies that the surgery is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the filler ruined my face. I regret ever done it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

Whether injectable substances completely disappear has historically been a point of contention in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face becomes somewhat waterlogged because its capacity to remove bodily fluid has been diminished.” Though studies into the area is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and additional studies initiated. An esteemed face specialist, commenting anonymously, says he would avoid using injectables in a patient because of the risks 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 plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she required to exit the injectable hamster wheel. After 24 months, she found herself choosing between a selection of recommended hotels in the city, 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 surgeon advised her that a facelift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Then he said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|