‘I Wasn’t Able to Even Open My Eyes. That’s The Extent of the Swelling I Was’

Onemanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the usual causes associated with a house full of loud preteen children, but because it’s the initial occasion she will reveal her recently altered face to friends and extended family. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I appear,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of people choosing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have 28-year-olds asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are built a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that’s what becomes lax and drags the skin downward with it.”

You risk performing surgery on people 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 excessive use of dermal fillers expands the face and causes looseness in the skin – combined with the common adoption of slimming medications, low-cost surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this major operation. Statistics show an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“People are asking now to appear as the optimal form of themselves and naturally the methods are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy entails elevating the superficial layer, the comprehensive lift releases the underlying structures underneath, enabling surgeons to reshape the face by moving the underlying layers, and preventing the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer 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 primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting numerous requests from clients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” 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 did it because the injectable ruined my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”

If injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Research have shown that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the fact that to some extent, the face becomes somewhat fluid-filled because its ability to remove lymphatic fluid has been diminished.” Although research into the topic is early-stage, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies initiated. An esteemed face specialist, commenting anonymously, says he would avoid using fillers in a patient because of the dangers they present. “A lot of doctors avoid talk about this, because the companies who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she required to exit the injectable hamster wheel. Two years later, she ended up choosing between a selection of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her doctor advised her that a facelift was the correct option for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her operation, 24 hours post she’d arrived solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, plus a three-day|