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

Onemanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. Not for the usual causes related to a home packed of loud preteen kids, but since it’s the initial occasion she will showcase her new face to acquaintances and extended family. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – look is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My spouse became emotional when he viewed me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ typical patient age range of 40 to 60. (Though most surgeons are eager to highlight the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a bit concerned when I observe individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, elevates the tissues in the face that start to sag as we grow older. “Our faces are structured a little like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and pulls the skin downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and causes laxity in the skin – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of novel, famous-figure-promoted operative methods are attracting a new kind of customer towards this invasive surgery. Statistics show an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the portion of youthful candidates is increasing, with 32% of facelifts now performed on patients aged 35-55.

“People are asking now to look like the optimal form of themselves and obviously the methods are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy entails lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, enabling surgeons to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by older methods. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a unified block 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 anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I underwent it because the injectable ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

If injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have shown that they seldom completely dissolve,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that to some extent, the face becomes slightly waterlogged because its ability to drain lymphatic fluid has been diminished.” Although studies into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been released, and additional studies announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would never use fillers in a client because of the dangers they pose. “Many surgeons avoid talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift might be what she needed to exit the cycle of treatments. Two years later, she ended up choosing between a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor recommended that a facial lift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, one day after she’d touched down solo in the country, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|