‘My Eyes Were So Swollen I Couldn’t Even Open Them’

Onemanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. It’s not due to the typical causes associated with a home packed of clamorous adolescent kids, but because it’s the initial occasion she will debut her recently altered face to acquaintances and relatives. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, 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 surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of six aesthetic surgeries, such as an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade prior to typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have 28-year-olds asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a bit concerned when I see individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Human faces are structured 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’s what causes aging; that is what loosens and sags and drags the skin down with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and causes laxity in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this major operation. Reports indicate an 8% increase in facelifts over the past 12 months in the UK; while a survey found that the portion of younger facelift patients is increasing, with 32% of facelifts 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 following,” says Orfaniotis. Currently, 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 facelift involves elevating the superficial layer, the comprehensive lift releases the underlying structures underneath, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “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 results in a authentic-appearing and longer-lasting outcome. It also means that the surgery is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at minimum not at the thirty years old. But long-term using injectable gels in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I did it because the filler ruined my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is additionally the fact that in a sense, the face becomes somewhat waterlogged because its ability to drain bodily fluid has been diminished.” Although studies into the area is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and further research announced. An esteemed face specialist, speaking on the condition of anonymity, says he would avoid using injectables in a client because of the risks they present. “Many doctors avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift could be what she needed to exit the injectable hamster wheel. After 24 months, she found herself selecting from a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d arrived solo in the country, she decided to add a mouth enhancement. “Then he said, ‘We will lift the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|