‘I Couldn’t Even Unseal My Eyes. That’s How Swollen I Was’

Onemanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the usual reasons related to a house full of loud preteen children, but because it’s the first time she will showcase her new face to friends and relatives. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not the way I appear,’” says the 30-year-old property agent from south Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My spouse became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, 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 rising count of individuals choosing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before typical surgeons’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see people choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Our faces are built a little like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and drags the dermis downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to laxity in the dermis – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed surgical techniques are attracting a different type of patient towards this invasive surgery. Reports show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey revealed that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy entails lifting the superficial layer, the comprehensive lift releases the facial ligaments beneath it, allowing doctors to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a passenger.” Lifting the whole facial structure as a unified block results in a more natural-looking and longer-lasting result. It additionally implies that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting numerous requests 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 injectable gels in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she says. “I underwent it because the filler harmed my face. I regret ever done it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”

Whether injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets slightly waterlogged because its ability to drain bodily fluid has been reduced.” Although research into the area is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would never use injectables in a patient because of the risks they pose. “Many doctors don’t want to talk about this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she had to keep replenishing it – especially as it started to migrate 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 could be what she needed to exit the cycle of treatments. After 24 months, she ended up selecting from a list of suggested accommodations in the city, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facial lift was the right solution for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down alone in Turkey, she decided to add a lip lift. “Then he stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we extract 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, including a three-day|