‘My Eyes Were So Swollen I Was Unable to Even Open Them’

Onemanda Preisinger feels anxious about her child’s impending 13th birthday party. Not for the usual reasons related to a home packed of clamorous preteen children, but since it’s the initial occasion she will reveal her new face to acquaintances and extended family. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not the way I appear,’” says the 30-year-old property agent from Southern Florida.

How she looks is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals electing to have a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are structured a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what becomes lax and pulls the skin downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and leads to laxity in the skin – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of new, celebrity-endorsed surgical techniques are attracting a new kind of customer towards this major operation. Reports indicate an 8% increase in facelifts over the past 12 months in the UK; while a study revealed that the portion of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged 35-55.

“People are asking now to look like the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift loosens the facial ligaments underneath, allowing doctors to reshape the face by moving the underlying layers, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a secondary element.” Elevating the whole facial structure as a single unit allows for a more natural-looking and longer-lasting outcome. It also means that the surgery is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the thirty years old. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the filler harmed my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

If dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘pillow face’ is also the reality that to some extent, the face becomes slightly waterlogged because its capacity to drain bodily fluid has been reduced.” Although studies into the area is early-stage, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using injectables in a patient because of the dangers they present. “Many doctors avoid talk about this, because the companies who make filler can be quite forceful.” He’s been told accounts, he says, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she had to keep adding more – especially as 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 needed to exit the cycle of treatments. Two years later, she found herself choosing between a selection of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facial lift was the correct option for the laxity she was finding in her face. She arranged a brow lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|