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

Onemanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. It’s not due to the usual causes associated with a home packed of clamorous adolescent children, but because it’s the first time she will reveal her recently altered face to acquaintances and relatives. “Clearly I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I look,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat surprising – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a growing number of individuals electing to undergo a facelift in their 20s and 30s – significantly before a ten years prior to most doctors’ usual candidate age of forty to sixty. (Though many specialists are eager to highlight the industry edict of: “We address genetics, not years.”) “I have 28-year-olds asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a facelift, elevates the ligaments in the face that start to sag as we grow older. “Our faces are built a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and pulls the dermis down with it.”

You risk performing surgery on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to laxity in the skin – alongside the common adoption of slimming medications, cut-price medical tourism, and the advancement of novel, celebrity-endorsed surgical techniques are driving a different type of patient towards this major operation. Reports indicate an 8% increase in facelifts over the last year in the UK; while a study found that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are asking now to look like the best version of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails lifting the superficial layer, the comprehensive lift releases the underlying structures beneath it, allowing doctors to restructure the face by moving the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor 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.” Elevating the entire soft tissue layer as a single unit results in a authentic-appearing and more durable result. It additionally implies that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at least not at the age of 30. But long-term using injectable gels in an attempt at “facial balancing” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look young,” she says. “I underwent it because the filler ruined my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the reality that in a sense, the face gets somewhat fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though research into the area is preliminary, warnings on injectables’ possible effects on the lymphatic system have been issued, and further research announced. An esteemed facial plastic surgeon, speaking anonymously, says he would never use fillers in a patient because of the risks they present. “A lot of doctors don’t want to 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 court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep replenishing it – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a list of suggested accommodations in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|