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

Onemanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. Not for the typical reasons associated with a house full of clamorous preteen children, but because it’s the initial occasion she will showcase her new face to acquaintances and extended family. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a little startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of half a dozen aesthetic surgeries, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the first time because I wasn’t able to 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: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of people choosing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before most doctors’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have 28-year-olds requesting facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I observe people opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and drags the skin down with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and causes laxity in the dermis – alongside the widespread use of slimming medications, cut-price surgical travel, and the development of new, famous-figure-promoted operative methods are attracting a different type of customer towards this invasive surgery. Statistics show an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“People are now requesting to look like the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy entails lifting the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, allowing surgeons to reshape the face by moving the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers 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 procedure is not just being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the filler harmed my face. I wish I had never using it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

Whether dermal fillers completely disappear has historically been a point of contention in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the reality that to some extent, the face becomes somewhat fluid-filled because its ability to drain bodily fluid has been reduced.” Though studies into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies initiated. An esteemed face specialist, commenting on the condition of anonymity, says he would never use fillers in a client because of the dangers they present. “Many doctors avoid talk about this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor recommended that a facelift was the right solution for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d touched down alone in the country, she decided to add a mouth enhancement. “Then he said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some cheek fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day operation, including a three-day|