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

Onemanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. It’s not due to the typical causes related to a house full of clamorous preteen kids, but since it’s the first time she will showcase her recently altered face to acquaintances and relatives. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I look,’” states the thirty-year-old real estate agent from south Florida.

How she looks is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though held together 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, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the first time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via online 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 plastic surgeons, Preisinger is one of a growing number of people electing to undergo a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that start to sag as we grow older. “Our faces are built a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and pulls the skin down with it.”

You risk operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and causes looseness in the dermis – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the development of new, famous-figure-promoted operative methods are driving a different type of patient towards this major operation. Statistics show an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are asking now to appear as the best version of themselves and obviously the methods are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy involves elevating the SMAS, the comprehensive lift releases the facial ligaments underneath, allowing surgeons to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We’re not putting stress on the skin because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin follows along as a passenger.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and more durable result. It also means that the procedure is not just being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the injectable ruined my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

If dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we term ‘pillow face’ is also the fact that to some extent, the face gets slightly waterlogged because its ability to drain bodily fluid has been reduced.” Though research into the area is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been released, and additional studies announced. An esteemed face specialist, commenting anonymously, mentioned he would avoid using fillers in a client because of the dangers they present. “Many surgeons don’t want to discussing this, because the manufacturers who produce filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – particularly when it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she needed to exit the cycle of treatments. After 24 months, she found herself selecting from a selection of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon recommended that a facelift was the correct option for the looseness she was experiencing in her face. She arranged a brow lift, a mid-facelift and a neck lift. The day before her operation, 24 hours post she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|