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

Onemanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the typical reasons related to a home packed of loud adolescent kids, but because it’s the first time she will reveal her recently altered face to friends and extended family. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not how I look,’” says the 30-year-old property agent from Southern Florida.

How she looks is, admittedly, a little startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – look is the outcome of six cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she explains to me via online call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade before typical surgeons’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds requesting facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe people choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Human faces are structured a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and pulls the skin down with it.”

You endanger operating on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and causes looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the development of novel, famous-figure-promoted surgical techniques are attracting a different type of patient towards this major operation. Statistics indicate an 8% increase in facelifts over the last year in the United Kingdom; while a study revealed that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are now requesting to appear as the best version of themselves and obviously the methods are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves lifting the SMAS, the deep plane facelift loosens the underlying structures underneath, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched appearance occasionally caused by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable outcome. It additionally implies that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at minimum not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “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 using it. If I had avoided the filler, I don’t think I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Although research into the area is early-stage, warnings on injectables’ potential impact on the lymphatic system have been issued, and additional studies initiated. An esteemed facial plastic surgeon, speaking anonymously, says he would never use injectables in a client because of the dangers they present. “Many doctors avoid discussing this, because the companies who produce injectables can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a list of suggested accommodations in the city, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her surgeon recommended that a facelift was the right solution for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she says. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|