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

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday party. Not for the usual causes related to a house full of clamorous preteen children, but since it’s the initial occasion she will showcase her recently altered face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a little startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My spouse teared up when he saw me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a rising count of people 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 most surgeons are eager to highlight the industry edict of: “We treat heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are structured a bit like onion layers,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that is what becomes lax and pulls the dermis down with it.”

You endanger performing surgery on individuals that have underlying problems. It’s not a practice for an conscientious surgeon to follow

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels stretches the face and causes laxity in the skin – alongside the common adoption of slimming medications, cut-price medical tourism, 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 past 12 months in the UK; while a study found that the portion of younger facelift patients is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

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

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the SMAS, the comprehensive lift releases the underlying structures underneath, allowing doctors to reshape the face by moving the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the filler harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is additionally the fact that in a sense, the face gets slightly fluid-filled because its capacity to drain lymphatic fluid has been diminished.” Though studies into the topic is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and further research announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using injectables in a patient because of the risks they pose. “Many doctors don’t want to talk about this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, 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 facial and neck surgery might be what she required to exit the cycle of treatments. Two years later, 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 planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facelift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her operation, 24 hours post she’d arrived alone in the country, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|