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

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. It’s not due to the usual causes related to a house full of loud adolescent children, but because it’s the first time she will reveal her recently altered face to friends and extended family. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I appear,’” says the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a little startling – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a growing number of people electing to have a facelift in their twenties and thirties – well over a decade before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have 28-year-olds requesting facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see people opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that start to sag as we age. “Our faces are structured a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and pulls the dermis down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when overuse of dermal fillers stretches the face and leads to laxity in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed operative methods are driving a new kind of patient towards this major operation. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a survey revealed that the portion of youthful candidates is growing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are asking now to appear as the best version of themselves and obviously the methods are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift involves lifting the superficial layer, the comprehensive lift releases the underlying structures underneath, enabling doctors to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the age of 30. 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 desired to appear youthful,” she clarifies. “I did it because the filler harmed my face. I regret ever done it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is also the reality that in a sense, the face gets slightly fluid-filled because its ability to drain lymphatic fluid has been reduced.” Although studies into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and further research announced. One highly regarded face specialist, commenting anonymously, says he would avoid using injectables in a client because of the risks they present. “Many doctors don’t want to talk about this, because the companies who make injectables can be quite forceful.” 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 injecting filler, she felt as if she had to keep adding more – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she required to exit the cycle of treatments. Two years later, she found herself selecting from a selection of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facelift was the correct option for the looseness she was finding in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The eve of her operation, 24 hours post she’d arrived alone in the country, she opted to include a lip lift. “Then he said, ‘We will elevate the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|