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

Onemanda Preisinger experiences worry about her child’s upcoming 13th birthday party. It’s not due to the typical reasons associated with a home packed of loud preteen children, but since it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not the way I appear,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a little surprising – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – look is the result of half a dozen aesthetic surgeries, including an minimally invasive 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 couldn’t even open my eyes. That’s how swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of individuals choosing to undergo a facelift in their 20s and 30s – well over a ten years before most doctors’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that start to sag as we age. “Human faces are structured a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and pulls the dermis down with it.”

You risk performing surgery on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and leads to laxity in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed surgical techniques are attracting a different type of patient towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the last year in the UK; while a survey revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on patients aged 35-55.

“People are asking now to appear as the optimal form of themselves and obviously the techniques are following,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails lifting the superficial layer, the comprehensive lift loosens the facial ligaments underneath, allowing doctors to restructure the face by repositioning the underlying layers, and preventing the taut, pulled appearance sometimes wrought by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Lifting the whole facial structure as a unified block results in a more natural-looking and longer-lasting result. It additionally implies that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I underwent it because the injectable harmed my face. I wish I had never using it. If I had avoided the filler, I don’t think I would be where I’m at currently.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the reality that to some extent, the face gets somewhat fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Although research into the area is preliminary, warnings on injectables’ potential impact on the body’s drainage have been released, and additional studies initiated. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would never use injectables in a client because of the risks they present. “A lot of surgeons avoid discussing this, because the manufacturers who produce injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a face and neck lift might be what she needed to finally step off the cycle of treatments. After 24 months, she found herself selecting from a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facelift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she says. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|