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

Onemanda Preisinger is nervous about her daughter’s impending 13th birthday party. It’s not due to the typical causes related to a house full of clamorous adolescent children, but because it’s the initial occasion she will debut her recently altered face to friends and extended family. “Obviously I’m going to tell everyone as they arrive, ‘For your information, this is not how I look,’” states the 30-year-old real estate agent from south Florida.

How she looks is, well, a little startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the result of half a dozen cosmetic procedures, including 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 couldn’t even open my eyes. That indicates swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of people choosing to have a facelift in their 20s and 30s – well over a ten years before typical surgeons’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that start to sag as we grow older. “Our faces are structured a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that is what ages us; that’s what loosens and sags and pulls the skin down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to looseness in the dermis – combined with the widespread use of weight-loss drugs, cut-price medical tourism, and the development of novel, celebrity-endorsed operative methods are attracting a new kind of patient towards this major operation. Statistics show an eight percent rise in facial lifts over the past 12 months in the UK; while a survey found that the portion of youthful candidates is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“People are asking now to look like the optimal form of themselves and naturally the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails elevating the SMAS, the deep plane facelift releases the facial ligaments beneath it, allowing doctors to reshape the face by repositioning the underlying layers, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. 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 longer-lasting result. It additionally implies that the surgery is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I did it because the injectable ruined my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be in this situation currently.”

If dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the reality that in a sense, the face gets slightly fluid-filled because its ability to drain bodily fluid has been diminished.” Although research into the area is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and further research initiated. One highly regarded face specialist, speaking on the condition of anonymity, says he would avoid using injectables in a patient because of the dangers they pose. “A lot of surgeons don’t want to talk about this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she needed to finally step off the cycle of treatments. Two years later, she found herself choosing between a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|