‘My Eyes Were So Swollen I Was Unable to Even Unseal Them’

Onemanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the usual causes related to a home packed of loud preteen children, but because it’s the initial occasion she will reveal her new face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not how I look,’” states the 30-year-old real estate agent from south Florida.

How she looks is, well, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the result of half a dozen cosmetic procedures, including an endoscopic mid-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 wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals electing to have a rhytidectomy in their 20s and 30s – well over a ten years prior to most doctors’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that start to sag as we grow older. “Human faces are built a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that is what loosens and sags and pulls the skin down with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and causes looseness in the dermis – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the development of new, celebrity-endorsed operative methods are attracting a different type of customer towards this major operation. Statistics show an eight percent rise in facial lifts over the last year in the UK; while a survey found that the percentage of youthful candidates is growing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“People are asking now to look like the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves lifting the superficial layer, the comprehensive lift loosens the underlying structures underneath, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Elevating the whole facial structure as a unified block results in a authentic-appearing and longer-lasting outcome. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the thirty years old. But long-term using injectable gels in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the filler harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states 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 slightly fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Although studies into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and additional studies initiated. One highly regarded face specialist, speaking anonymously, says he would avoid using fillers in a client because of the dangers they pose. “A lot of surgeons avoid discussing this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she needed to continue adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might be what she required to exit the cycle of treatments. Two years later, she found herself choosing between a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon advised her that a facelift was the correct option for the laxity she was experiencing in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d touched down alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|