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

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. Not for the typical reasons associated with a house full of loud adolescent kids, but because it’s the initial occasion she will reveal her new face to friends and relatives. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional when he viewed me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of people electing to have a rhytidectomy in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of 40 to 60. (Though many specialists are eager to highlight the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see people choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Human faces are built a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and pulls the skin downward with it.”

You risk operating on individuals that have underlying problems. It’s not a practice for an conscientious surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to laxity in the dermis – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the development of new, celebrity-endorsed operative methods are attracting a different type of customer towards this invasive surgery. Reports show an 8% increase in facial lifts over the past 12 months in the UK; while a survey found that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on patients aged 35-55.

“Patients are now requesting to appear as the best version of themselves and obviously the techniques are following,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails lifting the superficial layer, the comprehensive lift releases the underlying structures beneath it, allowing surgeons to reshape the face by moving the underlying layers, and avoiding the tight, stretched look occasionally caused by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue 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 longer-lasting result. It additionally implies that the surgery is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients 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 “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the injectable ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be in this situation right now.”

Whether injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is also the reality that to some extent, the face becomes somewhat fluid-filled because its ability to drain lymphatic fluid has been diminished.” Although research into the topic is preliminary, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using fillers in a patient because of the risks they pose. “A lot of surgeons avoid talk about this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor 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 list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facial lift was the right solution for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d arrived alone in Turkey, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|