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

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday party. It’s not due to the usual causes related to a home packed of loud preteen children, but because it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, 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 puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon 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: ‘Babe, 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 one of a rising count of individuals electing to have a rhytidectomy in their 20s and 30s – well over a decade before typical surgeons’ typical patient age range of forty to sixty. (Although most surgeons are eager to highlight the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Our faces are structured a bit like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and drags the dermis downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to looseness in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a new kind of customer towards this invasive surgery. Reports indicate an 8% increase in facelifts over the last year in the United Kingdom; while a study found that the portion of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, allowing surgeons to restructure the face by moving the underlying layers, and preventing the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting result. It also means that the surgery is not just 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 numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the filler ruined my face. I regret ever done it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”

If injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘pillow face’ is additionally the reality that to some extent, the face gets somewhat waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though studies into the area is early-stage, cautionary statements on injectables’ possible effects on the body’s drainage have been released, and additional studies announced. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would never use injectables in a patient because of the risks they pose. “Many surgeons don’t want to discussing this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – particularly when it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a selection of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facelift was the correct option for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The eve of her operation, one day after she’d touched down alone in the country, she opted to include a mouth enhancement. “Then he stated, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|