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

Onemanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. Not for the usual reasons related to a home packed of loud adolescent kids, but since it’s the initial occasion she will reveal her new face to friends and relatives. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat startling – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is among a rising count of individuals electing to have a facelift in their twenties and thirties – well over a decade before typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “Our faces are structured a bit like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that is what ages us; that’s what becomes lax and pulls the dermis down with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and causes looseness in the dermis – combined with the widespread use of slimming medications, low-cost medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are driving a different type of customer towards this invasive surgery. Reports indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“Patients are now requesting to appear as the optimal form of themselves and naturally the techniques are following,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the SMAS, the deep plane facelift loosens the facial ligaments beneath it, allowing doctors to restructure the face by repositioning the underlying layers, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Elevating the whole facial structure as a single unit results in a more natural-looking and more durable result. It additionally implies that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the injectable harmed my face. I wish I had never using it. If I had avoided the filler, I don’t believe I would be in this situation right now.”

If injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the reality that in a sense, the face gets slightly fluid-filled because its capacity to drain bodily fluid has been diminished.” Though research into the area is preliminary, warnings on injectables’ potential impact on the lymphatic system have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using injectables in a client because of the dangers they pose. “A lot of surgeons don’t want to discussing this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a face and neck lift might be what she needed to exit the cycle of treatments. After 24 months, she ended up choosing between a selection of suggested accommodations in the city, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution 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, one day after she’d arrived alone 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 remove some cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|