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

Onemanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the usual causes related to a house full of clamorous adolescent kids, but because it’s the initial occasion she will showcase her new face to acquaintances and extended family. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a little startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals electing to undergo a facelift in their twenties and thirties – significantly before a decade before most doctors’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Our faces are built a bit like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the dermis down with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and causes looseness in the dermis – alongside the common adoption of slimming medications, cut-price surgical travel, and the advancement of novel, celebrity-endorsed operative methods are driving a new kind of patient towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the last year in the UK; while a study revealed that the portion of youthful candidates is growing, with 32% of facelifts now performed on individuals aged 35-55.

“People are now requesting to look like the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, allowing doctors to restructure the face by moving the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the skin because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in 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 unified block allows for a authentic-appearing and more durable outcome. It also means that the procedure is no longer being used for the express purpose of youth preservation – 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 reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the thirty years old. But years of using injectable gels in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever done it. If I had avoided the filler, I don’t think I would be in this situation right now.”

If dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is also the fact that in a sense, the face becomes somewhat waterlogged because its capacity to drain bodily fluid has been diminished.” Though studies into the area is early-stage, warnings on injectables’ possible effects on the body’s drainage have been issued, and additional studies announced. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would never use injectables in a patient because of the dangers they present. “A lot of surgeons avoid discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. After 24 months, she found herself selecting from a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facelift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d arrived alone in Turkey, she opted to include a lip lift. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|