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

Onemanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. Not for the typical reasons associated with a house full of clamorous adolescent children, but since it’s the first time she will showcase her recently altered face to acquaintances and extended family. “Clearly I’m going to tell all guests as they come in, ‘Just so you know, this is not how I appear,’” says the 30-year-old property agent from south Florida.

Her appearance is, well, a somewhat startling – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial 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 house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of individuals choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a bit concerned when I observe individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that start to sag as we grow older. “Human faces are structured a little like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s 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 pursue

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and leads to looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are attracting a new kind of patient towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a study found that the percentage of youthful candidates is growing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are asking now to look like the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and longer-lasting outcome. It additionally implies that the procedure is not just being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late 20s, 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 done it. If I had avoided the injectable, I don’t think I would be where I’m at currently.”

If dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Research have shown that they seldom fully dissipate,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face becomes slightly waterlogged because its ability to drain bodily fluid has been reduced.” Though research into the topic is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would never use fillers in a patient because of the risks they pose. “A lot of doctors don’t want to discussing this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facelift 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 day before her surgery, one day after she’d touched down alone in Turkey, she decided to add a lip lift. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I believe if we extract some cheek fat, it will contour your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|