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

Onemanda Preisinger feels anxious about her daughter’s impending 13th birthday party. It’s not due to the usual causes associated with a house full of clamorous adolescent kids, but because it’s the initial occasion she will debut her recently altered face to friends and relatives. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” states the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My spouse became emotional when he saw me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade prior to most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds asking for facelifts,” 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 individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Our faces are structured a bit like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue called the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and drags the dermis down with it.”

You risk performing surgery on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and leads to looseness in the dermis – alongside the common adoption of slimming medications, low-cost medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are driving a different type of patient towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the last year in the UK; while a study found that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“People are now requesting to look like the optimal form of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy involves elevating the superficial layer, the comprehensive lift releases the facial ligaments underneath, allowing surgeons to reshape the face by repositioning the underlying layers, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable result. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” 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 think I would be in this situation right now.”

Whether injectable substances completely disappear has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the reality that in a sense, the face becomes somewhat waterlogged because its ability to remove bodily fluid has been diminished.” Though research into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would never use injectables in a patient because of the dangers they present. “A lot of surgeons don’t want to talk about this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she needed to continue adding more – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she needed to exit the cycle of treatments. Two years later, she ended up selecting from a selection of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The eve of her surgery, one day after she’d touched down solo in the country, she opted to include a lip lift. “Then he stated, ‘We will lift the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|