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

Onemanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the usual causes associated with a home packed of clamorous preteen children, but because it’s the first time she will reveal her new face to acquaintances and extended family. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not how I look,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – look is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even open my eyes. That indicates swollen 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 look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals choosing to undergo a rhytidectomy in their 20s and 30s – well over a decade prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Our faces are structured a bit like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and drags the skin 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, overuse of injectables – when overuse of dermal fillers stretches the face and leads to laxity in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the advancement of new, celebrity-endorsed surgical techniques are attracting a different type of patient towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the UK; while a survey revealed that the portion of younger facelift patients is increasing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“Patients are now requesting to look like the best version of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy entails lifting the SMAS, the deep plane facelift loosens the facial ligaments beneath it, allowing surgeons to restructure the face by moving the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Elevating the whole facial structure as a unified block allows for a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at least not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the injectable ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

If dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is additionally the reality that to some extent, the face becomes slightly waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though studies into the topic is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been released, and further research initiated. An esteemed facial plastic surgeon, commenting anonymously, says he would avoid using fillers in a patient because of the risks they pose. “A lot of doctors avoid discussing this, because the companies who make filler can be quite forceful.” He’s heard stories, he adds, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed 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 suggested that a facial and neck surgery could be what she required to exit the injectable hamster wheel. Two years later, she ended up selecting from a list of suggested accommodations in the city, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor recommended that a facelift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d arrived solo in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|