‘My Eyes Were So Swollen I Couldn’t Even Open Them’

Onemanda Preisinger is nervous about her child’s impending 13th birthday party. Not for the usual causes related to a home packed of loud adolescent kids, but since it’s the initial occasion she will showcase her recently altered face to acquaintances and relatives. “Clearly I’m going to tell all guests as they come in, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the first time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of people choosing to undergo a facelift in their 20s and 30s – significantly before a decade before most doctors’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the tissues in the face that begin to droop 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 superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and drags the dermis down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and causes looseness in the dermis – alongside the common adoption of slimming medications, cut-price surgical travel, and the advancement of new, celebrity-endorsed operative methods are attracting a different type of patient towards this major operation. Statistics show an 8% increase in facial lifts over the last year in the United Kingdom; while a study revealed that the portion of youthful candidates is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are asking now to appear as the best version of themselves and obviously the techniques are following,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves lifting the SMAS, the deep plane facelift releases the facial ligaments beneath it, enabling doctors to restructure the face by moving the underlying layers, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting tension on the skin because we’re going below, 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 skin follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing and more durable result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the filler harmed my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

Whether injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown 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 gets somewhat waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though studies into the topic is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and additional studies initiated. An esteemed face specialist, speaking anonymously, mentioned he would avoid using injectables in a client because of the risks they present. “Many surgeons don’t want to discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue adding more – particularly when 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 needed to exit the cycle of treatments. After 24 months, she ended up selecting from a selection of suggested accommodations in the city, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – 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 booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d arrived solo in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|