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

Onemanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. Not for the usual causes associated with a house full of clamorous preteen children, but because it’s the first time she will showcase her recently altered face to friends and relatives. “Obviously I’m going to tell all guests 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 somewhat startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she explains to me via online call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals electing to have a facelift in their 20s and 30s – significantly before a ten years prior to typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We treat heredity, not years.”) “I have individuals in their late twenties asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Our faces are built a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and drags the dermis downward 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 affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and leads to looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the development of new, celebrity-endorsed surgical techniques are attracting a different type of customer towards this major operation. Reports show an 8% increase in facelifts over the past 12 months in the UK; while a survey found that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“People are now requesting to appear as the best version of themselves and naturally the methods are following,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves elevating the superficial layer, the comprehensive lift loosens the underlying structures beneath it, allowing doctors to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a passenger.” 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 procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler ruined my face. I wish I had never using it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” says Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the reality that in a sense, the face gets slightly waterlogged because its capacity to drain lymphatic fluid has been diminished.” Although studies into the area is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using fillers in a patient because of the dangers they pose. “A lot of surgeons avoid talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she needed to exit the cycle of treatments. After 24 months, she ended up selecting from a list of suggested accommodations 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 eyelid surgery – but her doctor advised her that a facelift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, one day after she’d arrived solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|