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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual causes associated with a house full of loud preteen kids, but because it’s the first time she will reveal her new face to acquaintances and extended family. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not how I appear,’” states the thirty-year-old property agent from south Florida.

How she looks is, well, a little startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of people electing to undergo a rhytidectomy in their 20s and 30s – well over a decade prior to most doctors’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a facelift, elevates the ligaments in the face that start to sag as we age. “Human faces are structured a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and pulls the skin downward with it.”

You endanger operating on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to laxity in the dermis – alongside the common adoption of slimming medications, cut-price medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are driving a new kind of customer towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a survey revealed that the portion of younger facelift patients is growing, with 32% of facelifts now performed on patients aged 35-55.

“People are now requesting to appear as the best version of themselves and naturally the methods are following,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails elevating the superficial layer, the comprehensive lift releases the underlying structures beneath it, enabling doctors to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and more durable result. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I did it because the filler ruined my face. I regret ever done it. If I had avoided the filler, I don’t think I would be where I’m at currently.”

If dermal fillers completely disappear has long been a debated topic in the cosmetic field. “Studies have shown that they seldom fully dissipate,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the reality that in a sense, the face gets somewhat waterlogged because its capacity to remove lymphatic fluid has been diminished.” Though studies into the topic is early-stage, warnings on injectables’ potential impact on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would never use fillers in a client because of the dangers they present. “A lot of doctors don’t want to talk about this, because the companies who make filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a face and neck lift might be what she needed to exit the cycle of treatments. After 24 months, she ended up selecting from a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Then he said, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|