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

Onemanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. Not for the usual causes related to a house full of clamorous adolescent children, but because it’s the first time she will debut her new face to friends and extended family. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not the way I appear,’” says the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, including 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 couldn’t even open my eyes. That indicates swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among 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 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” states London-based cosmetic 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 observe people opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Human faces are structured a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that is what becomes lax and drags the skin down with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and causes laxity in the skin – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are driving a different type of patient towards this major operation. Statistics show an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on patients aged 35-55.

“People are asking now to look like the best version of themselves and obviously the techniques are following,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift loosens the underlying structures underneath, allowing doctors to restructure the face by moving the underlying layers, and avoiding the tight, stretched look sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a unified block 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 anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the injectable harmed my face. I wish I had never using it. If I didn’t have the filler, I don’t think I would be where I’m at currently.”

If dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Research have shown that not only do they rarely fully dissipate,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘pillow face’ is also the fact that in a sense, the face gets somewhat fluid-filled because its capacity to drain bodily fluid has been diminished.” Although studies into the topic is early-stage, warnings on injectables’ potential impact on the body’s drainage have been released, and further research announced. One highly regarded face specialist, commenting anonymously, says he would avoid using fillers in a patient because of the risks they present. “A lot of surgeons avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – particularly when it started to migrate 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 required to exit the cycle of treatments. Two years later, she found herself choosing between a list of suggested accommodations in Istanbul, texted 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 laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her operation, one day after she’d arrived solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|