‘My Eyes Were So Swollen I Was Unable to Even Open Them’

Onemanda Preisinger experiences worry about her child’s upcoming 13th birthday party. Not for the typical reasons related to a house full of clamorous adolescent kids, but because it’s the initial occasion she will reveal her recently altered 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 thirty-year-old property agent from south Florida.

How she looks is, well, a little surprising – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals choosing to have a facelift in their twenties and thirties – significantly before a decade prior to most doctors’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are built a little like onion layers,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and drags the dermis down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when overuse of injectable gels stretches the face and causes looseness in the skin – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the advancement of new, celebrity-endorsed operative methods are driving a different type of customer towards this invasive surgery. Reports show an eight percent rise in facelifts over the last year in the UK; while a survey revealed that the portion of youthful candidates is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are asking now to look like the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves lifting the superficial layer, the deep plane facelift releases the facial ligaments beneath it, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London 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 secondary element.” Lifting the entire soft tissue layer as a unified block results in a authentic-appearing and longer-lasting result. It also means that the surgery is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I wanted to look young,” she says. “I underwent it because the filler ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”

Whether dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Studies have indicated that they seldom fully dissipate,” says Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is also the reality that in a sense, the face becomes somewhat fluid-filled because its capacity to remove bodily fluid has been reduced.” Although studies into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and further research announced. An esteemed face specialist, commenting anonymously, says he would avoid using fillers in a patient because of the dangers they present. “A lot of doctors avoid talk about this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – particularly when it started to migrate to other parts 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 exit the injectable hamster wheel. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facelift was the right solution for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her surgery, 24 hours post she’d arrived alone in the country, she decided to add a mouth enhancement. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|