‘I Wasn’t Able to Even Unseal My Eyes. That’s The Extent of the Swelling I Was’

Onemanda Preisinger feels anxious about her child’s upcoming 13th birthday party. Not for the typical causes related to a home packed of clamorous preteen children, but since it’s the initial occasion she will debut her new face to acquaintances and extended family. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not the way I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My spouse teared up when he saw me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of people electing to undergo a rhytidectomy in their 20s and 30s – well over a decade before most doctors’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “Our faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and pulls the skin down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels expands the face and causes laxity in the skin – combined with the common adoption of slimming medications, low-cost medical tourism, and the advancement of new, celebrity-endorsed operative methods are attracting a new kind of patient towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a study revealed that the portion of younger facelift patients is growing, with one-third of procedures now performed on patients aged 35-55.

“People are asking now to look like the optimal form of themselves and naturally the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves elevating the superficial layer, the deep plane facelift loosens the underlying structures beneath it, allowing doctors to restructure the face by repositioning the underlying layers, and preventing the tight, stretched look sometimes wrought by older methods. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Elevating the whole facial structure as a unified block allows for a more natural-looking and more durable outcome. It additionally implies that the surgery is no longer being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I did it because the filler harmed my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

Whether dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the fact that to some extent, the face becomes slightly waterlogged because its capacity to remove lymphatic fluid has been reduced.” Though studies into the topic is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies announced. One highly regarded face specialist, commenting on the condition of anonymity, says he would never use fillers in a patient because of the dangers they pose. “Many surgeons avoid talk about this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a face and neck lift could be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facelift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her surgery, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|