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

Onemanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the usual causes associated with a home packed of loud adolescent children, but because it’s the initial occasion she will debut her recently altered face to acquaintances and relatives. “Clearly I’m going to tell everyone as they arrive, ‘For your information, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates puffy 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 look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of individuals choosing to have a rhytidectomy in their 20s and 30s – well over a decade prior to most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” states based in London cosmetic 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 individuals opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are structured a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that is what ages us; that is what loosens and sags and drags the dermis downward with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when overuse of dermal fillers expands the face and leads to looseness in the skin – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the development of new, celebrity-endorsed surgical techniques are attracting a different type of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey revealed that the percentage of youthful candidates is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“People are now requesting to appear as 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 method promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves lifting the superficial layer, the comprehensive lift releases the underlying structures beneath it, allowing surgeons to reshape the face by moving the underlying layers, and preventing the taut, pulled appearance occasionally caused by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and more durable result. 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 patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at least not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” 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.”

Whether injectable substances completely disappear has historically been a debated topic in the cosmetic field. “Research have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets slightly waterlogged because its capacity to drain bodily fluid has been diminished.” Though research into the area is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies announced. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would avoid using injectables in a patient because of the risks they pose. “A lot of surgeons don’t want to discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep adding more – 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 face and neck lift might be what she required to finally step off the injectable hamster wheel. After 24 months, she ended up selecting from a list of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d touched down alone in the country, she opted to include a lip lift. “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 including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|