‘I Wasn’t Able to Even Open My Eyes. That’s The Extent of the Swelling I Was’

Onemanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the usual reasons related to a house full of loud adolescent children, but since it’s the initial occasion she will reveal her new face to friends and extended family. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not how I look,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – appearance is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last 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 indicates swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of individuals electing to undergo a rhytidectomy in their 20s and 30s – significantly before a ten years prior to most doctors’ usual candidate age of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have 28-year-olds asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a facelift, lifts 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 top, then a stratum of supportive tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and pulls 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 pursue

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and causes laxity in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are attracting a different type of patient towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a study found that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are now requesting to look like the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves elevating the superficial layer, the deep plane facelift releases the facial ligaments underneath, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled look sometimes wrought by older methods. “We’re not putting stress on the skin because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor 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 single unit results in a more natural-looking and more durable outcome. It also means that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I did it because the injectable harmed my face. I regret ever done it. If I didn’t have the filler, I don’t believe I would be in this situation right now.”

If injectable substances completely disappear has historically been a debated topic in the cosmetic field. “Research have shown that they seldom fully dissipate,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the fact that in a sense, the face becomes slightly fluid-filled because its ability to remove bodily fluid has been diminished.” Though studies into the area is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and further research initiated. An esteemed facial plastic surgeon, speaking anonymously, says he would never use fillers in a patient because of the risks they pose. “Many doctors avoid talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – particularly when it began moving to different areas of her face. She was just 28 when a local plastic surgeon in the state suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. After 24 months, she found herself selecting from a selection of recommended hotels 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 recommended that a facelift was the right solution for the looseness she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d arrived alone in Turkey, she opted to include a lip lift. “Then he stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|