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

Onemanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. It’s not due to the typical causes associated with a home packed of loud preteen kids, but because it’s the initial occasion she will reveal her new face to acquaintances and relatives. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not how I look,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of six cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he saw me for the first time because I couldn’t even open 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 okay, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a rising count of people electing to have a rhytidectomy in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have 28-year-olds requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a somewhat worried when I see people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that begin to droop as we age. “Human faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and pulls the skin downward with it.”

You risk performing surgery on individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and leads to laxity in the skin – alongside the widespread use of slimming medications, low-cost surgical travel, and the development of new, famous-figure-promoted surgical techniques are driving a different type of customer towards this invasive surgery. Reports show an eight percent rise in facelifts over the last year in the United Kingdom; while a survey revealed that the portion of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now 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 promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the facial ligaments underneath, allowing doctors to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched look occasionally caused by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The skin comes with it as a secondary element.” Lifting the whole facial structure as a single unit allows for a more natural-looking and more durable result. It additionally implies that the surgery is not just being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the age of 30. But years of using injectable gels in an effort at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the injectable harmed my face. I wish I had never using it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is additionally the reality that to some extent, the face gets somewhat waterlogged because its ability to remove lymphatic fluid has been diminished.” Although studies into the topic is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and further research announced. One highly regarded face specialist, speaking on the condition of anonymity, says he would avoid using fillers in a patient because of the risks they pose. “Many surgeons don’t want to discussing this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she required to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a selection of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon advised her that a facelift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her surgery, one day after she’d touched down solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|