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

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. It’s not due to the typical causes related to a home packed of clamorous preteen children, but because it’s the first time she will showcase her new face to acquaintances and relatives. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not the way I appear,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of half a dozen aesthetic surgeries, such as an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of people electing to have a facelift in their twenties and thirties – well over a ten years before most doctors’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see 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 grow older. “Human faces are structured a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and pulls the dermis downward with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers stretches the face and causes laxity in the skin – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the development of novel, celebrity-endorsed operative methods are driving a new kind of customer towards this invasive surgery. 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 youthful candidates is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the best version of themselves and naturally the methods are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves lifting the SMAS, the deep plane facelift releases the underlying structures underneath, allowing doctors to reshape the face by moving the deeper tissue, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a secondary element.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting outcome. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on getting 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” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I did 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 where I’m at currently.”

Whether dermal fillers ever fully dissolve has long 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. One of the contributors 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 reduced.” Although research into the area is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies initiated. An esteemed face specialist, speaking anonymously, says he would avoid using injectables in a client because of the dangers they pose. “Many surgeons avoid discussing this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue adding more – especially as it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state 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 selecting from a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon advised her 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 neck lift. The day before her surgery, 24 hours post she’d arrived solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ He added, ‘I think if we remove some cheek 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|