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

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday party. It’s not due to the usual reasons associated with a house full of loud preteen kids, but since it’s the initial occasion she will debut her new face to acquaintances and extended family. “Obviously I’m going to tell everyone as they arrive, ‘For your information, this is not how I look,’” states the 30-year-old property agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she tells me via online call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of people electing to undergo a facelift in their twenties and thirties – well over a decade before most doctors’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are structured a bit like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and drags the skin downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an conscientious surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and causes laxity in the skin – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a different type of customer towards this major operation. Reports show an eight percent rise in facial lifts over the last year in the United Kingdom; while a study found that the portion of younger facelift patients is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“People are asking now to appear as the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional facelift involves elevating the SMAS, the deep plane facelift releases the facial ligaments beneath it, allowing surgeons to reshape the face by moving the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by older methods. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable result. It additionally implies that the surgery is not just being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” notes 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 attempt at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

If injectable substances ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have shown that they seldom fully dissipate,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we term ‘pillow face’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Though studies into the area is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. One highly regarded face specialist, commenting anonymously, says he would never use fillers in a patient because of the risks they pose. “A lot of doctors avoid talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – especially as it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a face and neck lift might be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a selection of recommended hotels in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facial lift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a neck lift. The eve of her surgery, 24 hours post she’d arrived alone in the country, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt 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|