‘I Couldn’t Even Open My Eyes. That’s The Extent of the Swelling I Was’

Onemanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. Not for the usual causes related to a home packed of loud adolescent kids, but because it’s the initial occasion she will showcase her new face to acquaintances and extended family. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not how I look,’” states the thirty-year-old property agent from south Florida.

Her appearance is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My spouse became emotional when he viewed me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ typical patient age range of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Human faces are built a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that is what becomes lax and drags the dermis downward with it.”

You risk performing surgery on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to looseness in the skin – alongside the common adoption of slimming medications, low-cost surgical travel, and the development of new, celebrity-endorsed operative methods are driving a different type of customer towards this invasive surgery. Statistics show an 8% increase in facelifts over the last year in the United Kingdom; while a study revealed that the portion of youthful candidates is growing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the methods are following,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the superficial layer, the deep plane facelift loosens the underlying structures beneath it, allowing doctors to restructure the face by moving the underlying layers, and preventing the taut, pulled appearance occasionally caused by older methods. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a passenger.” Lifting the whole facial structure as a unified block allows for a more natural-looking and longer-lasting outcome. It also means that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she says. “I underwent it because the filler harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the fact that in a sense, the face becomes slightly fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Though studies into the area is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and further research initiated. An esteemed face specialist, speaking anonymously, mentioned he would never use injectables in a client because of the risks they present. “A lot of surgeons don’t want to discussing 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 raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a face and neck lift might be what she required to exit the injectable hamster wheel. After 24 months, she found herself choosing between a list of recommended hotels in the city, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facial lift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d arrived alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|