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

Onemanda Preisinger feels anxious about her daughter’s impending 13th birthday party. Not for the typical reasons related to a house full of loud adolescent kids, but since it’s the first time she will debut her new face to acquaintances and extended family. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of half a dozen aesthetic surgeries, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even open my eyes. That’s how swollen I was,” she tells me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals choosing to have a rhytidectomy in their twenties and thirties – significantly before a decade before most doctors’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that start to sag as we age. “Our faces are structured a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and pulls the skin downward with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to laxity in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of new, famous-figure-promoted operative methods are attracting a different type of customer towards this major operation. Reports show an eight percent rise in facelifts over the last year in the UK; while a survey found that the portion of youthful candidates is growing, with one-third of procedures now performed on patients aged 35-55.

“Patients are asking now to look like the optimal form of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves elevating the superficial layer, the comprehensive lift releases the underlying structures underneath, enabling doctors to restructure the face by moving the underlying layers, and preventing the tight, stretched look sometimes wrought by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and more durable result. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look young,” she says. “I underwent it because the injectable ruined my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

If injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘pillow face’ is also the reality that to some extent, the face gets slightly fluid-filled because its ability to remove bodily fluid has been diminished.” Although studies into the topic is preliminary, warnings on injectables’ potential impact on the body’s drainage have been released, and additional studies initiated. An esteemed facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the dangers they pose. “Many doctors avoid talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state suggested that a face and neck lift could be what she needed to finally step off the injectable hamster wheel. After 24 months, she ended up selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon advised her that a facelift was the correct option for the looseness she was finding 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 decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I believe if we remove some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|