‘I Couldn’t Even Unseal My Eyes. That’s How Swollen I Was’

Onemanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. Not for the typical reasons associated with a house full of loud preteen kids, but because it’s the first time she will showcase her new face to friends and relatives. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I look,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last month. “My spouse teared up when he saw me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of people choosing to undergo a facelift in their twenties and thirties – well over a ten years before most doctors’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that start to sag as we age. “Human faces are structured a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and drags the dermis down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and causes laxity in the skin – combined with the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of new, famous-figure-promoted operative methods are driving a new kind of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the last year in the UK; while a survey found that the portion of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are now requesting to look like the best version of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves lifting the SMAS, the deep plane facelift loosens the facial ligaments beneath it, enabling surgeons to restructure the face by moving the underlying layers, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a single unit allows for 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 cosmetic field terms it – but for “beautification” and contouring, too. “We’re getting numerous requests from clients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But years of using injectable gels in an effort at “facial balancing” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I underwent it because the injectable ruined my face. I wish I had never using it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we call ‘pillow face’ is additionally the reality that in a sense, the face becomes somewhat fluid-filled because its capacity to drain bodily fluid has been diminished.” Though studies into the topic is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and further research announced. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would never use fillers in a patient because of the dangers they pose. “A lot of surgeons avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep 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 injectable hamster wheel. Two years later, she found herself selecting from a list of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a cheek lift and a neck lift. The day before her operation, one day after she’d arrived alone in Turkey, she decided to add a lip lift. “Then he stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|