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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual reasons related to a house full of clamorous preteen children, but because it’s the initial occasion she will showcase her recently altered face to acquaintances and extended family. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, well, a little surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of six aesthetic surgeries, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a rising count of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a ten years prior to most doctors’ typical patient age range of forty to sixty. (Although many specialists are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are structured a little like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that is what causes aging; that is what loosens and sags and drags the skin downward with it.”

You risk operating on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and leads to looseness in the dermis – combined with the widespread use 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 eight percent rise in facial lifts over the last year in the UK; while a survey found that the percentage of youthful candidates is increasing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy entails lifting the superficial layer, the comprehensive lift loosens the underlying structures underneath, allowing doctors to reshape the face by repositioning the underlying layers, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and more durable result. It additionally implies that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the filler harmed my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets somewhat fluid-filled because its capacity to remove bodily fluid has been diminished.” Although studies into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking anonymously, says he would avoid using injectables in a patient because of the dangers they present. “A lot of doctors don’t want to discussing this, because the companies who make filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep adding more – particularly when it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift could be what she needed to finally step off the cycle of treatments. Two years later, she found herself selecting from a list of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facial lift was the right solution for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her surgery, 24 hours post she’d arrived solo in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|