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

Onemanda Preisinger is nervous about her child’s impending 13th birthday celebration. It’s not due to the usual causes related to a house full of clamorous preteen kids, but because it’s the first time she will reveal her recently altered face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I look,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, well, a little startling – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – look is the result of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My spouse teared up when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ typical patient age range of 40 to 60. (Though most surgeons are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Our faces are built a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that’s what becomes lax and drags the skin downward with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to laxity in the dermis – alongside the widespread use of slimming medications, low-cost medical tourism, and the development of new, celebrity-endorsed surgical techniques are driving a different type of patient towards this invasive surgery. Reports indicate an 8% increase in facelifts over the past 12 months in the UK; while a survey found that the percentage of youthful candidates is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are now requesting to appear as the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails lifting the SMAS, the deep plane facelift loosens the underlying structures beneath it, allowing surgeons to restructure the face by moving the underlying layers, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a passenger.” Elevating the whole facial structure as a unified block results in a authentic-appearing and more durable result. It additionally implies that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the filler ruined my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”

If dermal fillers ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the fact that in a sense, the face becomes somewhat waterlogged because its capacity to drain lymphatic fluid has been diminished.” Although studies into the area is early-stage, warnings on injectables’ possible effects on the lymphatic system have been released, and additional studies announced. An esteemed facial plastic surgeon, commenting anonymously, says he would never use fillers in a patient because of the risks they present. “A lot of doctors avoid discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift could be what she required to exit the injectable hamster wheel. After 24 months, she found herself selecting from a list of recommended hotels in the city, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her surgery, 24 hours post she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|