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

Onemanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. Not for the typical reasons related to a house full of loud adolescent kids, but since it’s the first time she will debut her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they come in, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – look is the result of half a dozen cosmetic procedures, including an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how swollen I was,” she tells me via online call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a rising count of people choosing to undergo a rhytidectomy in their twenties and thirties – well over a ten years prior to typical surgeons’ typical patient age range of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major surgery, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that begin to droop as we grow older. “Human faces are structured a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the SMAS. Consider 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 risk operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and leads to laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the advancement of novel, celebrity-endorsed operative methods are attracting a different type of customer towards this invasive surgery. Statistics show an 8% increase in facelifts over the last year in the UK; while a study revealed that the portion of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves lifting the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the whole facial structure as a single unit results in a more natural-looking and more durable result. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – 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 entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I underwent it because the injectable harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

Whether injectable substances completely disappear has historically been a point of contention in the cosmetic field. “Research have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘pillow face’ is additionally the fact that in a sense, the face gets somewhat waterlogged because its ability to drain bodily fluid has been diminished.” Although research into the topic is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been issued, and further research initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would never use fillers in a patient because of the risks they present. “Many doctors don’t want to talk about this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she had to keep adding more – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a selection of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facial lift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d arrived alone in the country, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|