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

Onemanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the typical reasons 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 extended family. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I appear,’” states the thirty-year-old property agent from south Florida.

How she looks is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – look is the outcome of half a dozen cosmetic procedures, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via online call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals electing to undergo a facelift in their 20s and 30s – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have 28-year-olds requesting facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are structured a bit like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue called the SMAS. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that is what loosens and sags and pulls the dermis down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to looseness in the skin – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this major operation. Statistics show an 8% increase in facial lifts over the last year in the United Kingdom; while a study found that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for patients aged 35-55.

“People are asking now to appear as the best version of themselves and naturally the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, enabling doctors to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the whole facial structure as a single unit allows for a more natural-looking and more durable result. It also means that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I did it because the injectable ruined my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that in a sense, the face becomes slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though research into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and additional studies announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use fillers in a patient because of the risks they pose. “Many surgeons don’t want to talk about this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep 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 facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. Two years later, 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 eyelid surgery – better known as blepharoplasty – but her surgeon recommended that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d arrived alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|