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

Onemanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. Not for the usual reasons associated with a house full of clamorous preteen children, but because it’s the first time she will showcase her new face to acquaintances and extended family. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not how I look,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the result of six aesthetic surgeries, such as an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via online call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of individuals choosing to undergo a facelift in their twenties and thirties – well over a ten years prior to most doctors’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that begin to droop as we grow older. “Human faces are built a little like onion layers,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what loosens and sags and drags the skin downward with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when overuse of injectable gels expands the face and leads to looseness in the dermis – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed operative methods are driving a new kind of patient towards this major operation. Reports show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study found that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are now requesting to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves elevating the SMAS, the comprehensive lift loosens the underlying structures underneath, allowing doctors to restructure the face by moving the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a passenger.” Lifting the whole facial structure as a unified block results in 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 rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look 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 in this situation right now.”

Whether injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is also the reality that in a sense, the face becomes slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Though studies into the area is early-stage, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and further research initiated. An esteemed facial plastic surgeon, commenting anonymously, says he would avoid using fillers in a client because of the risks they present. “Many doctors don’t want to talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a face and neck lift could be what she required to finally step off the cycle of treatments. After 24 months, she found herself selecting from a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor advised her that a facelift was the correct option for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, 24 hours post she’d touched down solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|