‘My Eyes Were So Swollen I Couldn’t Even Open Them’

Onemanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. It’s not due to the usual causes related to a house full of loud adolescent kids, but because it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to tell all guests as they come in, ‘Just so you know, this is not how I appear,’” says the 30-year-old property agent from south Florida.

Her appearance is, well, a little startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – look is the outcome of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My spouse teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she tells me via online call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a rising count of people choosing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, alternatively called a facelift, elevates the ligaments in the face that begin to droop as we age. “Our faces are structured a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and pulls 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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to looseness in the skin – combined with the widespread use of slimming medications, low-cost medical tourism, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a different type of patient towards this major operation. Reports show an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey revealed that the portion of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are asking now to look like the best version of themselves and naturally 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 more traditional facelift entails elevating the SMAS, the comprehensive lift loosens the underlying structures beneath it, enabling doctors to restructure the face by repositioning the deeper tissue, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting stress on the dermis because we’re targeting deeper, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis comes with it as a passenger.” Elevating the whole facial structure as a unified block allows for a more natural-looking and longer-lasting outcome. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned 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 “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is also the fact that to some extent, the face becomes somewhat waterlogged because its ability to remove lymphatic fluid has been diminished.” Though research into the area is early-stage, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and additional studies announced. An esteemed facial plastic surgeon, speaking anonymously, says he would avoid using injectables in a client because of the risks they present. “A lot of surgeons avoid discussing this, because the manufacturers who produce injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she needed to finally step off the cycle of treatments. After 24 months, she found herself selecting from a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facelift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|