‘I Wasn’t Able to Even Unseal My Eyes. That’s The Extent of the Swelling I Was’

Onemanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. Not for the typical causes associated with a house full of loud preteen children, but because it’s the initial occasion she will debut her new face to friends and relatives. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I look,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she explains to me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a growing number of people electing to undergo a rhytidectomy in their twenties and thirties – significantly before a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have 28-year-olds requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that begin to droop as we grow older. “Our faces are built a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and drags the skin downward with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when overuse of injectable gels stretches the face and leads to looseness in the skin – alongside the widespread use of slimming medications, cut-price medical tourism, and the development of new, famous-figure-promoted surgical techniques are driving a different type of patient towards this major operation. Statistics show an eight percent rise in facelifts over the last year in the UK; while a survey found that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to look like the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves lifting the SMAS, the deep plane facelift releases the underlying structures beneath it, allowing doctors to restructure the face by moving the underlying layers, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting result. It additionally implies that the surgery is not just being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the age of 30. But years of using injectable gels in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the injectable ruined 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.”

If dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Research have shown that they seldom fully dissipate,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the reality that to some extent, the face gets somewhat waterlogged because its ability to remove lymphatic fluid has been reduced.” Though research into the topic is early-stage, warnings on injectables’ possible effects on the body’s drainage have been issued, and additional studies announced. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would avoid using fillers in a patient because of the risks they pose. “A lot of surgeons avoid talk about this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she needed to finally step off the cycle of treatments. After 24 months, she ended up choosing between a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facial lift 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 arrived alone in the country, she opted to include a lip lift. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|