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

Onemanda Preisinger feels anxious about her child’s upcoming 13th birthday party. Not for the usual reasons associated with a home packed of loud preteen kids, but because it’s the first time she will reveal her recently altered face to friends and extended family. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I look,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, well, a little startling – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of people choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a ten years before most doctors’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Human faces are built a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and drags the skin down with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and causes looseness in the dermis – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted operative methods are attracting a different type of patient towards this major operation. Statistics show an 8% increase in facelifts over the last year in the UK; while a survey revealed that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are now requesting to look like the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional facelift entails elevating the SMAS, the comprehensive lift loosens the underlying structures underneath, allowing doctors to reshape the face by moving the deeper tissue, and preventing the taut, pulled look occasionally caused by older methods. “We avoid placing stress on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Lifting the whole facial structure as a unified block results in a authentic-appearing and more durable result. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the injectable ruined my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

Whether injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is additionally the reality that in a sense, the face gets slightly waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though studies into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and further research initiated. One highly regarded face specialist, commenting anonymously, says he would avoid using fillers in a client because of the dangers they present. “Many doctors avoid discussing this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors 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 – especially as it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she needed to exit the cycle of treatments. Two years later, she ended up selecting from a list of suggested accommodations in the city, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d touched down alone in the country, she decided to add a mouth enhancement. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day operation, including a three-day|