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

Onemanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual reasons related to a house full of loud preteen kids, but since it’s the first time she will debut her recently altered face to friends and relatives. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I look,’” says the 30-year-old property agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a growing number of people choosing to undergo a rhytidectomy in their twenties and thirties – well over a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds requesting facelifts,” says London-based 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 somewhat worried when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Human faces are structured a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and pulls the dermis downward with it.”

You endanger performing surgery on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and causes laxity in the skin – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are attracting a new kind of patient towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the last year in the UK; while a study revealed that the percentage of youthful candidates is increasing, with one-third of procedures now performed on patients aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy entails lifting the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, enabling doctors to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled look sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting outcome. It additionally implies that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using injectable gels in an effort at “facial balancing” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she clarifies. “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 where I’m at currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have shown that they seldom completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the fact that in a sense, the face gets slightly fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though studies into the area is early-stage, warnings on injectables’ potential impact on the lymphatic system have been released, and further research announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using fillers in a client because of the risks they pose. “Many doctors don’t want to discussing this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – especially as it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. After 24 months, she ended up selecting from a list of recommended hotels in Istanbul, 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 doctor recommended that a facial lift was the right solution for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her operation, one day after she’d touched down solo in Turkey, she decided to add a lip lift. “Then he stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|