‘I Wasn’t Able to Even Unseal My Eyes. That’s How Swollen I Was’

Onemanda Preisinger feels anxious about her child’s impending 13th birthday celebration. It’s not due to the typical reasons related to a home packed of loud adolescent children, but since it’s the first time she will debut her new face to acquaintances and extended family. “Clearly I’m going to tell all guests as they come in, ‘Just so you know, this is not how I appear,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, including an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, last month. “My spouse teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals choosing to have a facelift in their twenties and thirties – significantly before a ten years before most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the tissues in the face that begin to droop as we age. “Our faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the SMAS. Think of the facial framework 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 operating on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to looseness in the skin – combined with the widespread use of slimming medications, cut-price medical tourism, and the development of new, celebrity-endorsed surgical techniques are driving a new kind of customer towards this major operation. Reports show an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift entails lifting the SMAS, the deep plane facelift loosens the underlying structures beneath it, enabling surgeons to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the filler harmed my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

If dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the reality that in a sense, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Though research into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using injectables in a patient because of the risks they pose. “Many surgeons don’t want to discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she needed to continue adding more – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facial lift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d arrived alone in the country, she opted to include a lip lift. “Then he said, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|