‘My Eyes Were So Swollen I Couldn’t Even Open Them’

Onemanda Preisinger feels anxious about her child’s upcoming 13th birthday party. Not for the usual causes associated with a house full of loud preteen children, but because it’s the initial occasion she will debut her new face to acquaintances and extended family. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I appear,’” states the thirty-year-old property agent from south Florida.

Her appearance is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – look is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw 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 house. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is among a rising count of individuals electing to have a facelift in their 20s and 30s – significantly before a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have 28-year-olds asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Human faces are built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the SMAS. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that’s what loosens and sags and pulls the dermis down with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and causes looseness in the skin – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, celebrity-endorsed operative methods are attracting a different type of patient towards this major operation. Reports show an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are asking now to appear as the best version of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails lifting the superficial layer, the deep plane facelift releases the underlying structures beneath it, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin follows along as a passenger.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and more durable outcome. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “enhancement” 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 getting a facial lift – at least not at the thirty years old. 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 wanted to look young,” she says. “I underwent it because the filler ruined my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be where I’m at currently.”

Whether injectable substances completely disappear has long been a point of contention in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is additionally the fact that to some extent, the face gets somewhat fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though research into the area is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would never use injectables in a patient because of the risks they present. “Many surgeons avoid discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she had to keep adding more – 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 face and neck lift might be what she needed to exit the cycle of treatments. After 24 months, she ended up choosing between a list of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facial lift 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 day before her operation, one day after she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|