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

Onemanda Preisinger experiences worry about her child’s impending 13th birthday party. Not for the typical reasons related to a house full of clamorous preteen kids, but because it’s the first time she will debut her recently altered face to acquaintances and extended family. “Obviously I’m going to tell everyone as they arrive, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a little startling – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the result of half a dozen aesthetic surgeries, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade prior to typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are eager to highlight the professional guideline of: “We address genetics, not age.”) “I have 28-year-olds requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Our faces are built a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that is what becomes lax and pulls the dermis downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and causes looseness in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are attracting 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 study found that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are asking now to look like the optimal form of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the trending procedure 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 more traditional rhytidectomy involves elevating the superficial layer, the deep plane facelift releases the underlying structures beneath it, enabling doctors to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by older methods. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at least not at the age of 30. 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 “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”

Whether dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is additionally the reality that in a sense, the face gets slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Though studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and further research initiated. One highly regarded facial plastic surgeon, commenting anonymously, says he would never use injectables in a patient because of the dangers they present. “A lot of surgeons avoid talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her doctor advised her that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The eve of her operation, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|