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

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday party. Not for the typical reasons related to a house full of loud adolescent children, but since it’s the initial occasion she will reveal her new face to friends and extended family. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” says the 30-year-old real estate 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 – look is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the first time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a ten years prior to typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” says based in London 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 individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, elevates the tissues in the face that start to sag as we age. “Human faces are structured a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and drags the dermis downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and causes laxity in the skin – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are driving a new kind of customer towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the last year in the UK; while a survey revealed that the portion of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves elevating the SMAS, the comprehensive lift releases the facial ligaments underneath, enabling surgeons to reshape the face by moving the deeper tissue, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Lifting the whole facial structure as a unified block allows for a more natural-looking and longer-lasting outcome. It also means that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the injectable harmed my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

Whether 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. A contributing factor to what we term ‘pillow face’ is also the reality that to some extent, the face gets somewhat fluid-filled because its ability to remove bodily fluid has been diminished.” Although research into the topic is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been released, and further research initiated. One highly regarded face specialist, commenting anonymously, says he would never use fillers in a patient because of the risks they pose. “A lot of doctors don’t want to talk about this, because the companies who make filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue adding more – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in the state suggested that a face and neck lift could be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facelift was the correct option for the looseness she was experiencing in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her operation, 24 hours post she’d touched down alone in Turkey, she opted to include a lip lift. “Then he stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|