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

Onemanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the typical reasons related to a home packed 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 arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a little startling – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the result of six cosmetic procedures, such as an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even open my eyes. That indicates swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of people choosing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see individuals opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that start to sag as we grow older. “Human faces are built a bit like onion layers,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and pulls the dermis down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to laxity in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a new kind of patient towards this major operation. Reports show an 8% increase in facelifts over the last year in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves lifting the superficial layer, the comprehensive lift loosens the underlying structures beneath it, allowing surgeons to restructure the face by moving the underlying layers, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and more durable result. It additionally implies 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 “enhancement” and contouring, too. “We’re getting numerous requests from clients 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 thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear young,” she clarifies. “I did it because the injectable harmed my face. I regret ever 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 debated topic in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that in a sense, the face gets somewhat fluid-filled because its capacity to remove bodily fluid has been diminished.” Although studies into the topic is preliminary, warnings on injectables’ potential impact on the body’s drainage have been released, and further research initiated. An esteemed face specialist, commenting on the condition of anonymity, says he would avoid using injectables in a client because of the dangers they pose. “A lot of doctors don’t want to discussing this, because the companies who make injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – particularly when it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she needed to exit the injectable hamster wheel. Two years later, she found herself choosing between a list of recommended hotels in the city, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor recommended that a facial lift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d arrived solo in the country, she opted to include a lip lift. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|