‘I Wasn’t Able to Even Open My Eyes. That’s How Swollen I Was’

Onemanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. It’s not due to the typical causes associated with a home packed of clamorous adolescent children, but because it’s the first time she will showcase her new face to friends and extended family. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I appear,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, 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 indicates puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of people choosing to undergo a facelift in their twenties and thirties – well over a decade before typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a facelift, elevates the tissues in the face that start to sag as we grow older. “Our faces are built a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue called the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and pulls the dermis downward with it.”

You risk operating on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and leads to looseness in the dermis – combined with the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of novel, famous-figure-promoted operative methods are attracting a new kind of patient towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study found that the portion of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are now requesting to appear as the optimal form of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the SMAS, the comprehensive lift releases the underlying structures underneath, enabling doctors to reshape the face by moving the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. 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 procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But years of using injectable gels in an effort at “facial balancing” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I underwent it because the filler harmed my face. I wish I had never using it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”

If dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Research have indicated that they seldom 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 becomes slightly fluid-filled because its ability to drain bodily fluid has been diminished.” Although studies into the area is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been released, and further research announced. An esteemed face specialist, speaking on the condition of anonymity, says he would never use injectables in a client because of the dangers they pose. “Many doctors don’t want to discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a list of recommended hotels in the city, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon advised her that a facelift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d arrived alone in the country, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|