‘I Wasn’t Able to Even Open 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 associated with a house full of loud adolescent kids, but because it’s the first time she will reveal her recently altered face to friends and extended family. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not how I look,’” states the thirty-year-old real estate agent from south Florida.

How she looks is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up 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 online call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of people electing to undergo a facelift in their twenties and thirties – well over a decade before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds requesting facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, elevates the tissues in the face that start to sag as we grow older. “Human faces are built a bit like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and pulls the skin down with it.”

You endanger operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and causes laxity in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of new, celebrity-endorsed operative methods are attracting a new kind of customer towards this invasive surgery. Statistics show an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the portion of youthful candidates is growing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves lifting the SMAS, the comprehensive lift loosens the facial ligaments underneath, allowing doctors to restructure the face by moving the underlying layers, and preventing the tight, stretched appearance sometimes wrought by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable outcome. It also means that the procedure is not just being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

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 “facial balancing” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I desired to appear young,” she clarifies. “I did it because the injectable ruined my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

If injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘pillow face’ is also the reality that to some extent, the face becomes somewhat fluid-filled because its ability to remove lymphatic fluid has been reduced.” Though studies into the topic is preliminary, warnings on injectables’ possible effects on the body’s drainage have been released, and additional studies announced. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would never use injectables in a client because of the dangers they present. “Many surgeons don’t want to talk about this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep 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 the state suggested that a face and neck lift might be what she needed to finally step off the cycle of treatments. Two years later, she ended up choosing between a list of suggested accommodations in the city, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor advised her that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her operation, 24 hours post she’d touched down alone in Turkey, she decided to add a lip lift. “Then he stated, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she says. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|