‘My Eyes Were So Swollen I Was Unable to Even Open Them’

Onemanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the usual causes related to a home packed of loud adolescent children, but because it’s the initial occasion she will showcase her new face to acquaintances and relatives. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not the way I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My spouse teared up when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she explains to me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of people choosing to undergo a facelift in their 20s and 30s – significantly before a decade prior to most doctors’ typical patient age range of 40 to 60. (Though many specialists are eager to highlight the industry edict of: “We treat heredity, not years.”) “I have individuals in their late twenties requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, elevates the tissues in the face that begin to droop as we grow older. “Human faces are built a little like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the SMAS. Consider the SMAS as the structural foundation of the face. And that is what ages us; that’s what becomes lax and drags the skin down with it.”

You risk operating on people that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and causes looseness in the dermis – combined with the widespread use of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a new kind of customer towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the last year in the UK; while a study found that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves lifting the SMAS, the deep plane facelift loosens the underlying structures underneath, enabling surgeons to restructure the face by moving the deeper tissue, and preventing the taut, pulled look occasionally caused by older methods. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in 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 allows for a more natural-looking and more durable result. It also means that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing 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” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the filler ruined my face. I regret ever done it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

If injectable substances completely disappear has historically been a point of contention in the cosmetic field. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the fact that in a sense, the face becomes slightly fluid-filled because its ability to remove lymphatic fluid has been diminished.” Though research into the area is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and additional studies announced. An esteemed face specialist, speaking anonymously, says he would never use fillers in a client because of the risks they pose. “Many surgeons avoid talk about this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep adding more – particularly when it started to migrate 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 could be what she needed to exit the injectable hamster wheel. Two years later, she ended up choosing between a list of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for 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 booked a forehead lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d arrived solo in the country, she opted to include a lip lift. “Then he stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|