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

Onemanda Preisinger experiences worry about her child’s impending 13th birthday party. It’s not due to the usual reasons related to a house full of clamorous preteen kids, but since it’s the initial occasion she will showcase her new face to friends and relatives. “Clearly I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I look,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the first time because I wasn’t able to even open my eyes. That indicates swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of people choosing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before most doctors’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are built a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and drags the dermis downward with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and causes laxity in the dermis – combined with the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of novel, famous-figure-promoted operative methods are attracting a different type of customer towards this major operation. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged 35-55.

“People are asking now 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 technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves elevating the SMAS, the comprehensive lift releases the underlying structures underneath, enabling surgeons to restructure the face by moving the deeper tissue, and avoiding the taut, pulled look sometimes wrought by older methods. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and more durable result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But years of using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler harmed my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

Whether injectable substances completely disappear has historically been a point of contention in the cosmetic field. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets somewhat fluid-filled because its capacity to drain bodily fluid has been diminished.” Though research into the topic is early-stage, cautionary statements on injectables’ possible effects on the body’s drainage have been released, and further research initiated. One highly regarded face specialist, commenting on the condition of anonymity, says he would never use injectables in a patient because of the dangers they pose. “Many surgeons avoid talk about this, because the manufacturers who produce filler can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state proposed that a face and neck lift could be what she required to finally step off the cycle of treatments. Two years later, she found herself choosing between a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facelift was the right solution for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift 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. “Then he said, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|