‘I Wasn’t Able to Even Unseal My Eyes. That’s How Swollen I Was’

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday party. It’s not due to the usual causes associated with a home packed of clamorous preteen kids, but because it’s the initial occasion she will showcase her recently altered face to friends and relatives. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not the way I look,’” says the 30-year-old property agent from south Florida.

How she looks is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My spouse teared up when he viewed me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their twenties and thirties – significantly before a ten years before most doctors’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have 28-year-olds 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 bit concerned when I observe individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are built a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what loosens and sags and pulls the skin down with it.”

You risk operating on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and leads to looseness in the dermis – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the advancement of new, famous-figure-promoted operative methods are driving a different type of customer towards this invasive surgery. Reports show an eight percent rise in facelifts over the last year in the UK; while a survey revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on patients aged 35-55.

“People are asking now to appear as the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails lifting the SMAS, the deep plane facelift releases the underlying structures beneath it, enabling doctors to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched look occasionally caused by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting outcome. It also means that the procedure is not just being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the injectable harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its ability to remove lymphatic fluid has been diminished.” Though studies into the topic is early-stage, warnings on injectables’ possible effects on the lymphatic system have been released, and additional studies initiated. One highly regarded face specialist, speaking anonymously, says he would never use fillers in a patient because of the risks they present. “Many surgeons avoid discussing this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. After 24 months, she ended up choosing between a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a neck lift. The day before her operation, 24 hours post she’d arrived alone in Turkey, she opted to include a lip lift. “Then he said, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|