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

Onemanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the typical causes associated with a house full of loud adolescent children, but because 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 arrive, ‘For your information, this is not how I look,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat startling – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse became emotional when he saw me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of people electing to undergo a rhytidectomy in their 20s and 30s – well over a decade prior to most doctors’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have 28-year-olds asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a bit concerned when I see individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Human faces are built a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and drags the skin downward with it.”

You risk operating on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and causes looseness in the dermis – combined with the widespread use of slimming medications, low-cost surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a different type of patient towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of younger facelift patients is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves lifting the SMAS, the deep plane facelift releases the facial ligaments beneath it, allowing surgeons to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched look occasionally caused by older methods. “We avoid placing stress on the skin 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 adjusted. The skin follows along as a passenger.” Elevating the whole facial structure as a unified block allows for a more natural-looking and more durable result. It additionally implies that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the age of 30. But long-term using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

If injectable substances completely disappear has historically been a point of contention in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the reality that to some extent, the face becomes somewhat waterlogged because its ability to remove bodily fluid has been reduced.” Though research into the topic is early-stage, warnings on injectables’ possible effects on the lymphatic system have been released, and further research initiated. An esteemed face specialist, commenting on the condition of anonymity, says he would never use fillers in a patient because of the risks they present. “A lot of surgeons don’t want to discussing this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon 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 selection of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her surgeon advised her that a facelift was the right solution for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Then he said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|