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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. Not for the typical causes related to a home packed of loud adolescent kids, but because it’s the initial occasion she will showcase her recently altered face to friends and extended family. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a little startling – her face swollen and unnaturally tightened, as though held together by heavy-duty 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, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a growing number of individuals choosing to undergo a facelift in their 20s and 30s – well over a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Our faces are built a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and pulls the skin downward with it.”

You endanger operating on people that have underlying problems. It’s not advisable for an conscientious 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 skin – combined with the widespread use of slimming medications, cut-price medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are driving a new kind of customer towards this major operation. Reports show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study found that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“People are now requesting to appear as the optimal form of themselves and naturally the techniques are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails lifting the superficial layer, the deep plane facelift releases the underlying structures underneath, allowing surgeons to reshape the face by moving the underlying layers, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a secondary element.” Lifting the whole facial structure as a unified block results in a more natural-looking and more durable result. It also means that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look young,” she says. “I underwent it because the filler ruined my face. I regret ever done it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

If injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the fact that to some extent, the face gets slightly waterlogged because its ability to remove bodily fluid has been diminished.” Although studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and further research announced. An esteemed facial plastic surgeon, speaking anonymously, says he would avoid using injectables in a patient because of the dangers they pose. “A lot of doctors don’t want to talk about this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep adding more – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she needed to exit the cycle of treatments. Two years later, she ended up selecting from a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d arrived solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|