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

Onemanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the typical causes related to a home packed of clamorous preteen children, but because it’s the initial occasion she will showcase her new face to friends and extended family. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the thirty-year-old property agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My spouse teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of people electing to have a facelift in their twenties and thirties – well over a ten years prior to typical surgeons’ usual candidate age of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Understanding the Facelift Procedure

A facelift, alternatively called a facelift, lifts the ligaments in the face that begin to droop as we age. “Our faces are built a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and pulls the dermis downward with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and causes laxity in the skin – combined with the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of new, famous-figure-promoted operative methods are driving a different type of patient towards this invasive surgery. Reports show an eight percent rise in facelifts over the last year in the UK; while a survey revealed that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the best version of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional facelift entails elevating the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, enabling doctors to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by older methods. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The dermis comes with it as a passenger.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting outcome. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied 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 did it because the injectable harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be where I’m at right now.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets somewhat waterlogged because its capacity to remove bodily fluid has been reduced.” Although studies into the topic is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. One highly regarded face specialist, speaking on the condition of anonymity, mentioned he would avoid using injectables in a patient because of the risks they pose. “Many surgeons avoid talk about this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep replenishing it – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she needed to finally step off the cycle of treatments. After 24 months, she ended up choosing between a list of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d touched down solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day operation, including a three-day|