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

Onemanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the usual causes related to a house full of clamorous adolescent children, but because it’s the initial occasion she will debut her recently altered face to acquaintances and relatives. “Obviously I’m going to inform everyone as they come in, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, including an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of individuals choosing to have a rhytidectomy in their 20s and 30s – well over a ten years prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We treat genetics, 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 head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see people choosing it as a personal preference.”

Understanding the Facelift Procedure

A facelift, also known as a facelift, elevates the ligaments in the face that start to sag as we grow older. “Our faces are built a bit like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and drags the skin downward with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers stretches the face and leads to laxity in the skin – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the development of new, celebrity-endorsed operative methods 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 UK; while a survey found that the percentage of youthful candidates is increasing, with one-third of procedures now performed on patients aged 35-55.

“Patients are asking now to look like the best version of themselves and obviously the methods are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the facial ligaments underneath, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Lifting the whole facial structure as a single unit allows for a more natural-looking and more durable result. It also means that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the injectable ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we term ‘pillow face’ is additionally the reality that to some extent, the face becomes somewhat waterlogged because its capacity to remove bodily fluid has been reduced.” Although research into the topic is preliminary, warnings on injectables’ potential impact on the lymphatic system have been released, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would never use injectables in a patient because of the risks they present. “A lot of doctors avoid talk about this, because the companies who make filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her surgery, one day after she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We will elevate the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|