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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. Not for the typical reasons associated with a home packed of loud preteen kids, but since it’s the initial occasion she will showcase her recently altered face to acquaintances and relatives. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not how I appear,’” states the 30-year-old real estate agent from south Florida.

How she looks is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, 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 tells me via online call from her home. “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 Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of people electing to undergo a rhytidectomy in their twenties and thirties – significantly before a ten years before most doctors’ 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 facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I observe individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that begin to droop as we age. “Human faces are built a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and pulls the skin down with it.”

You risk operating on people that have underlying problems. 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 expands the face and causes looseness in the skin – alongside the widespread use of weight-loss drugs, low-cost surgical travel, and the development of new, famous-figure-promoted operative methods are attracting a different type of patient towards this major operation. Statistics show an eight percent rise in facial lifts over the last year in the United Kingdom; while a study found that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients are now requesting to look like the best version of themselves and obviously the methods are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy entails lifting the superficial layer, the comprehensive lift releases the facial ligaments beneath it, enabling doctors to restructure the face by moving the underlying layers, and preventing the tight, stretched look sometimes wrought by older methods. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting result. It additionally implies that the procedure is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at least not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” implied that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I did it because the injectable ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be where I’m at right now.”

If injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we term ‘pillow face’ is additionally the fact that in a sense, the face becomes slightly waterlogged because its ability to remove bodily fluid has been diminished.” Although research into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and further research announced. One highly regarded facial plastic surgeon, commenting anonymously, says he would avoid using fillers in a patient because of the risks they present. “Many doctors avoid talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a list of recommended hotels in the city, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the right solution for the looseness she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d arrived solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|