‘I Couldn’t Even Open My Eyes. That’s The Extent of the Swelling I Was’

Onemanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the usual reasons related to a home packed of loud adolescent children, but because it’s the first time she will debut her new face to acquaintances and relatives. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not how I look,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even open my eyes. That indicates swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of people choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a ten years before most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that’s what loosens and sags and drags the skin down with it.”

You risk operating on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and leads to laxity in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of new, famous-figure-promoted operative methods are driving a new kind of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the last year in the UK; while a survey revealed that the portion of youthful candidates is growing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and naturally the techniques are following,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails elevating the SMAS, the deep plane facelift releases the underlying structures underneath, allowing surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting result. It additionally implies 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 “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I did it because the injectable ruined my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be in this situation right now.”

If dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly waterlogged because its capacity to drain bodily fluid has been reduced.” Although studies into the topic is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies initiated. An esteemed facial plastic surgeon, speaking anonymously, says he would avoid using injectables in a client because of the dangers they present. “Many doctors avoid discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she had to keep replenishing it – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she required to exit the injectable hamster wheel. After 24 months, she found herself selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor 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 neck lift. The eve of her surgery, 24 hours post she’d arrived solo in Turkey, she opted to include a lip lift. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|