‘I Couldn’t Even Unseal My Eyes. That’s The Extent of the Swelling I Was’

Onemanda Preisinger experiences worry about her child’s impending 13th birthday party. It’s not due to the typical causes associated with a home packed of clamorous adolescent kids, but since it’s the first time she will reveal her new face to friends and relatives. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I look,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – appearance is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last 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 puffy I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a ten years prior to typical surgeons’ usual candidate age of forty to sixty. (Though many specialists are eager to highlight the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that start to sag as we age. “Our faces are built a bit like onion layers,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and pulls the skin down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to laxity in the dermis – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this major operation. Reports indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a study found that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and naturally the techniques are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails elevating the superficial layer, the deep plane facelift loosens the underlying structures beneath it, allowing surgeons to restructure the face by repositioning the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by older methods. “We’re not putting stress on the skin because we’re going below, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin follows along as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”

If injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have shown that they seldom fully dissipate,” 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 in a sense, the face becomes somewhat fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Although studies into the topic is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using fillers in a client because of the risks they present. “Many doctors avoid talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – particularly when it began moving to different areas of her face. She was just 28 when a local plastic surgeon in the state proposed that a facial and neck surgery might be what she needed to exit the cycle of treatments. Two years later, she ended up choosing between a list of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d arrived alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day operation, including a three-day|