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

Onemanda Preisinger feels anxious about her child’s upcoming 13th birthday party. It’s not due to the typical causes associated with a home packed of loud preteen children, but because it’s the first time she will debut her new face to acquaintances and extended family. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not the way I appear,’” states the 30-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of individuals choosing to have a facelift in their 20s and 30s – well over a ten years before most doctors’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the tissues in the face that start to sag as we age. “Human faces are built a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue called the SMAS. Consider the facial framework as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and pulls the dermis downward with it.”

You risk operating on people that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and leads to laxity in the skin – combined with the common adoption of slimming medications, cut-price medical tourism, and the development of novel, celebrity-endorsed operative methods are attracting a new kind of patient towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study found that the portion of youthful candidates is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are now requesting to look like the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves lifting the SMAS, the comprehensive lift releases the facial ligaments underneath, enabling doctors to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We avoid placing stress on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Lifting the whole facial structure as a single unit allows for a more natural-looking and more durable result. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at least not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the filler ruined my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”

If injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the fact that in a sense, the face gets slightly waterlogged because its ability to remove bodily fluid has been diminished.” Although studies into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and further research announced. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would avoid using injectables in a client because of the dangers they pose. “A lot of surgeons avoid discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she required to exit the injectable hamster wheel. Two years later, she found herself choosing between a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the looseness she was finding in her face. She arranged a brow lift, a cheek lift and a neck lift. The day before her operation, one day after she’d touched down alone in the country, she decided to add a lip lift. “Then he said, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|