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

Onemanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. It’s not due to the typical reasons associated with a house full of loud adolescent kids, but because it’s the first time she will reveal her recently altered face to acquaintances and relatives. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I appear,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the result of six cosmetic procedures, including an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via online call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of people electing to have a facelift in their twenties and thirties – well over a decade before most doctors’ typical patient age range of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds requesting facelifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called 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,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and pulls the dermis downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and leads to looseness in the dermis – alongside the common adoption of slimming medications, low-cost surgical travel, and the development of novel, celebrity-endorsed surgical techniques are driving a new kind of customer towards this invasive surgery. Statistics indicate 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 one-third of procedures now conducted for patients aged 35-55.

“People are asking now to appear as the best version of themselves and obviously the methods are following,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift releases the underlying structures underneath, allowing doctors to restructure the face by moving the deeper tissue, and avoiding the tight, stretched look occasionally caused by older methods. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and more durable result. It additionally implies that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the filler harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”

Whether injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face becomes somewhat fluid-filled because its capacity to drain lymphatic fluid has been diminished.” Although studies into the area is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and further research initiated. One highly regarded facial plastic surgeon, speaking anonymously, says he would never use injectables in a patient because of the dangers they pose. “Many surgeons don’t want to discussing this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state suggested that a face and neck lift might be what she required to exit the injectable hamster wheel. Two years later, she found herself choosing between a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facelift was the correct option for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d arrived alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I believe if we remove some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|