‘My Eyes Were So Puffy I Was Unable to Even Open Them’

Onemanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the usual reasons related to a home packed of loud preteen kids, but since it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a growing number of people electing to undergo a rhytidectomy in their 20s and 30s – well over a ten years prior to typical surgeons’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I see individuals opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we grow older. “Human faces are built a little like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and pulls the skin downward with it.”

You risk performing surgery on people that have underlying problems. 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 causes laxity in the dermis – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of new, celebrity-endorsed operative methods are driving a new kind of customer towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a survey revealed that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients 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 deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift involves lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, enabling doctors to reshape the face by moving the deeper tissue, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and more durable result. It also means that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But long-term using injectable gels in an effort at “symmetry correction” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the injectable harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be where I’m at right now.”

If dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the fact that in a sense, the face becomes slightly fluid-filled because its ability to remove bodily fluid has been reduced.” Although research into the area is preliminary, warnings on injectables’ potential impact on the lymphatic system have been issued, and additional studies initiated. An esteemed facial plastic surgeon, speaking anonymously, says he would avoid using fillers in a patient because of the risks they pose. “A lot of surgeons avoid talk about this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a face and neck lift could be what she needed to exit the injectable hamster wheel. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her doctor advised her that a facelift was the correct option for the looseness she was experiencing in her face. She booked a brow lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d touched down solo in Turkey, she decided to add a lip lift. “Then he said, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will contour your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|