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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the usual causes related to a house full of clamorous preteen children, but because it’s the initial occasion she will showcase her new face to acquaintances and extended family. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not how I look,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the outcome of six aesthetic surgeries, including an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of individuals choosing to have a rhytidectomy in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic 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 observe people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Our faces are built a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax 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 follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and causes looseness in the dermis – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are attracting a different type of customer towards this major operation. Statistics indicate an 8% increase in facial lifts over the past 12 months in the UK; while a survey revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, 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

Where a more traditional facelift involves elevating the superficial layer, the deep plane facelift releases the facial ligaments underneath, allowing doctors to restructure the face by moving the underlying layers, and avoiding the tight, stretched look occasionally caused by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Lifting the whole facial structure as a single unit results in a authentic-appearing and longer-lasting result. It additionally implies that the surgery is not just being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she says. “I underwent it because the injectable ruined my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the reality that in a sense, the face becomes slightly fluid-filled because its capacity to drain bodily fluid has been diminished.” Although research into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, speaking anonymously, says he would avoid using injectables in a client because of the dangers they present. “Many surgeons don’t want to talk about this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she had to keep adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – 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 operation, 24 hours post she’d touched down alone in Turkey, she decided to add a lip lift. “Then he said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we remove some buccal 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 surgery, plus a three-day|