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

Onemanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. Not for the usual reasons associated with a home packed of loud adolescent kids, but because it’s the initial occasion she will showcase her new face to acquaintances and relatives. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not how I appear,’” states the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – look is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of people electing to have a rhytidectomy in their 20s and 30s – well over a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major surgery, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that start to sag as we age. “Human faces are structured a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and drags the dermis down with it.”

You risk operating on people 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 injectable gels expands the face and leads to looseness in the dermis – alongside the common adoption of slimming medications, low-cost surgical travel, and the advancement of novel, famous-figure-promoted operative methods are attracting a different type of customer towards this major operation. Reports show an eight percent rise in facial lifts over the past 12 months in the UK; while a study found that the portion of younger facelift patients is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves elevating the superficial layer, the comprehensive lift releases the facial ligaments beneath it, allowing doctors to reshape the face by moving the underlying layers, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting stress on the dermis because we’re going below, 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 repositioned. The dermis follows along as a secondary element.” Elevating the whole facial structure as a unified block results in a authentic-appearing and more durable outcome. It additionally implies that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the filler harmed my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”

If dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the reality that in a sense, the face becomes slightly fluid-filled because its ability to drain lymphatic fluid has been reduced.” Though research into the area is early-stage, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies initiated. 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 present. “A lot of surgeons avoid discussing this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she required to exit the cycle of treatments. After 24 months, she found herself choosing between a selection of recommended hotels in Istanbul, 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 surgeon recommended that a facelift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d arrived solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|