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

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. It’s not due to the typical causes associated with a house full of loud preteen children, but since it’s the first time she will showcase her recently altered face to friends and relatives. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not how I look,’” states the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a little surprising – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of individuals electing to have a rhytidectomy in their twenties and thirties – well over a ten years before most doctors’ usual candidate age of forty to sixty. (Although most surgeons are eager to highlight the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds asking for facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe people choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Our faces are structured a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that is what ages us; that is what loosens and sags and pulls the dermis downward with it.”

You risk operating on people that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and causes laxity in the skin – combined with the widespread use of slimming medications, low-cost medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are driving a new kind of patient towards this major operation. Reports indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a study found that the portion of youthful candidates is increasing, with 32% of facelifts now performed on patients aged 35-55.

“People are now requesting to appear as the best version of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift entails elevating the SMAS, the deep plane facelift releases the underlying structures beneath it, enabling doctors to restructure the face by moving the deeper tissue, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and more durable result. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

Whether injectable substances completely disappear has historically been a point of contention in the cosmetic field. “Research have indicated that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is also the reality that to some extent, the face becomes somewhat fluid-filled because its ability to remove bodily fluid has been diminished.” Though studies into the area is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and further research initiated. One highly regarded facial plastic surgeon, commenting anonymously, says he would never use fillers in a client because of the dangers they pose. “A lot of doctors don’t want to discussing this, because the companies who produce filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she had to keep adding more – especially as it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. Two years later, she found herself selecting from a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her surgery, 24 hours post she’d arrived alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, plus a three-day|