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

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

How she looks is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of individuals choosing to undergo a rhytidectomy in their twenties and thirties – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have 28-year-olds requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that start to sag as we age. “Human faces are built a bit like onion layers,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that is what ages us; that’s what becomes lax and drags the dermis down with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an conscientious surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and leads to laxity in the dermis – alongside the common adoption of slimming medications, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are attracting a different type of customer towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the past 12 months in the UK; while a survey found that the percentage of youthful candidates is growing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are now requesting to appear as the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy entails lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, allowing doctors to reshape the face by moving the underlying layers, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis comes with it as a passenger.” Lifting the whole facial structure as a unified block allows for a authentic-appearing and more durable result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the filler ruined my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

If injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Research have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the fact that to some extent, the face becomes somewhat fluid-filled because its ability to drain lymphatic fluid has been reduced.” Although studies into the area is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and additional studies initiated. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would never use fillers in a client because of the risks they pose. “A lot of surgeons avoid discussing this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery could be what she needed to exit the cycle of treatments. After 24 months, she found herself selecting from a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in the country, 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 remove some cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|