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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. Not for the usual causes associated with a house full of clamorous preteen children, but because it’s the first time she will reveal her recently altered face to friends and extended family. “Clearly I’m going to inform everyone as they arrive, ‘Just so you know, this is not the way I look,’” states the 30-year-old property agent from Southern Florida.

How she looks is, well, a somewhat startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – look is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals choosing to have a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have 28-year-olds requesting facial lifts,” says London-based 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.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that start to sag as we age. “Human faces are built a bit like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and pulls the dermis downward with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and causes looseness in the skin – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of new, famous-figure-promoted operative methods are driving a different type of patient towards this invasive surgery. Reports indicate an eight percent rise in facelifts over the past 12 months in the UK; while a survey revealed that the portion of youthful candidates is growing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves elevating the SMAS, the comprehensive lift releases the facial ligaments beneath it, allowing doctors to restructure the face by moving the deeper tissue, and preventing the tight, stretched appearance occasionally caused by more traditional techniques. “We’re not putting stress on the dermis because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a single unit allows for a authentic-appearing and more durable result. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting numerous requests from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I did it because the injectable harmed my face. I wish I had never using it. If I didn’t have the filler, I don’t believe I would be in this situation right now.”

If dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can block lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face becomes somewhat waterlogged because its capacity to remove bodily fluid has been diminished.” Although studies into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and further research initiated. One highly regarded face specialist, speaking on the condition of anonymity, mentioned he would never use fillers in a patient because of the risks they pose. “A lot of doctors don’t want to talk about this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – especially as it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she needed to exit the injectable hamster wheel. After 24 months, she found herself choosing between a selection of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor advised her that a facial lift was the correct option for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she says. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|