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

Onemanda Preisinger feels anxious about her child’s impending 13th birthday celebration. It’s not due to the usual causes associated with a home packed of clamorous adolescent kids, but since it’s the initial occasion she will debut her recently altered face to acquaintances and extended family. “Obviously I’m going to tell everyone 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, well, a little surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last 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 swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals electing to have a facelift in their 20s and 30s – well over a ten years prior to typical surgeons’ typical patient age range of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties 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 surgery, and I’m a bit concerned when I see people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Human faces are built a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and pulls the skin downward with it.”

You risk operating on people that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and leads to looseness in the dermis – combined with the widespread use of slimming medications, low-cost medical tourism, and the development of new, famous-figure-promoted surgical techniques are driving a different type of patient towards this major operation. Statistics show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and naturally the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, allowing surgeons to restructure the face by repositioning the deeper tissue, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re targeting deeper, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting outcome. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at least not at the thirty years old. But long-term using injectable gels in an effort at “facial balancing” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I underwent it because the injectable 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 right now.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have shown that they seldom fully dissipate,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘pillow face’ is additionally the fact that to some extent, the face gets somewhat waterlogged because its capacity to drain lymphatic fluid has been diminished.” Although research into the topic is preliminary, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the dangers they pose. “A lot of surgeons avoid talk about this, because the companies who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – especially as it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a face and neck lift might be what she needed to exit the injectable hamster wheel. After 24 months, she found herself choosing between a list of suggested accommodations in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a cheek lift and a neck lift. The eve of her surgery, 24 hours post she’d touched down solo in the country, she opted to include a lip lift. “Then he stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (£16,500) for the half-day operation, including a three-day|