‘I Couldn’t Even Open My Eyes. That’s How Swollen I Was’

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. Not for the usual causes associated with a house full of clamorous adolescent kids, but since it’s the first time she will debut her new face to friends and extended family. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not the way I appear,’” says the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the outcome of six aesthetic surgeries, including an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of people choosing to have a facelift in their twenties and thirties – well over a ten years before most doctors’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that begin to droop as we age. “Our faces are structured a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and pulls the skin downward with it.”

You endanger performing surgery 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 excessive use of dermal fillers stretches the face and causes looseness in the skin – combined with the widespread use of slimming medications, cut-price surgical travel, and the development of novel, famous-figure-promoted surgical techniques are driving a different type of patient towards this major operation. Reports indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the portion of youthful candidates is increasing, with one-third of procedures now conducted for patients aged 35-55.

“People are asking now to look like the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the facial ligaments underneath, enabling surgeons to restructure the face by moving the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and more durable result. It also means that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers 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 in this situation currently.”

Whether injectable substances completely disappear has historically been a point of contention in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” states Grover, “but they move 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 fluid-filled because its ability to remove lymphatic fluid has been reduced.” Although studies into the area is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and further research announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use fillers in a patient because of the risks they present. “Many doctors avoid talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she had to keep adding more – particularly when it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state proposed that a facial and neck surgery could be what she needed to finally step off the cycle of treatments. Two years later, she ended up choosing between a selection of recommended hotels in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facelift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|