‘My Eyes Were So Swollen I Was Unable to Even Open Them’

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday party. It’s not due to the typical reasons related to a home packed of loud adolescent kids, but because it’s the first time she will reveal her recently altered face to friends and extended family. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not how I look,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a somewhat startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a rising count of people choosing to undergo a facelift in their 20s and 30s – well over a decade prior to most doctors’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are built a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue called the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and drags the skin down with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when overuse of injectable gels stretches the face and leads to laxity in the dermis – alongside the common adoption of slimming medications, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are attracting a new kind of patient towards this major operation. Statistics show an 8% increase in facial lifts over the last year in the UK; while a survey found that the portion of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails 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 sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and longer-lasting outcome. It additionally implies that the surgery is not just being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the injectable harmed 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.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Research have shown that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the fact that to some extent, the face gets somewhat waterlogged because its capacity to drain lymphatic fluid has been diminished.” Though studies into the topic is preliminary, warnings on injectables’ potential impact on the lymphatic system have been released, and additional studies initiated. One highly regarded face specialist, speaking anonymously, mentioned he would avoid using fillers in a patient because of the dangers they present. “Many doctors don’t want to talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she required to exit the cycle of treatments. After 24 months, she found herself choosing between a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – 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 arranged a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d arrived solo in the country, she decided to add a mouth enhancement. “Then he said, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|