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

Onemanda Preisinger feels anxious about her daughter’s impending 13th birthday party. It’s not due to the typical causes related to a home packed of clamorous adolescent kids, but since it’s the first time she will reveal her new face to acquaintances and relatives. “Obviously I’m going to tell everyone as they arrive, ‘For your information, this is not the way I look,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of individuals choosing to undergo a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds asking for facelifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major surgery, and I’m a somewhat worried when I see individuals opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that start to sag as we age. “Our faces are structured a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that’s what ages us; that is what becomes lax and pulls the dermis down with it.”

You risk operating on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to looseness in the dermis – combined with the widespread use of weight-loss drugs, cut-price medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are driving a different type of customer towards this invasive surgery. Statistics show an 8% increase in facelifts over the last year in the UK; while a study revealed that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged 35-55.

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

Advanced Lifting Method

Where a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift releases the facial ligaments beneath it, allowing surgeons to reshape the face by moving the underlying layers, and preventing the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin follows along as a passenger.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting outcome. It also means that the surgery is not just being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the thirty years old. But long-term using injectable gels in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be where I’m at currently.”

Whether injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Research have shown that they seldom completely dissolve,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face gets slightly fluid-filled because its capacity to drain lymphatic fluid has been diminished.” Although studies into the area is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been released, and additional studies initiated. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would never use fillers in a client because of the risks they present. “A lot of surgeons don’t want to talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery could be what she needed to exit the cycle of treatments. After 24 months, she ended up selecting from a selection of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facial lift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a cheek lift and a neck lift. The eve of her operation, 24 hours post she’d arrived solo in the country, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|