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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical reasons associated with a house full of clamorous preteen kids, but because it’s the initial occasion she will reveal her recently altered face to acquaintances and relatives. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My spouse teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of people choosing to undergo a facelift in their twenties and thirties – well over a decade before most doctors’ typical patient age range of forty to sixty. (Although most surgeons are eager to highlight the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are built a little like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that’s what becomes lax and drags the skin downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and causes laxity in the dermis – combined with the common adoption of slimming medications, cut-price surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are driving a different type of customer towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the last year in the United Kingdom; while a survey revealed that the portion of younger facelift patients is increasing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“People are now requesting to appear as the optimal form of themselves and naturally the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails lifting the SMAS, the deep plane facelift loosens the facial ligaments beneath it, enabling doctors to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis 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 repositioned. The dermis comes with it as a secondary element.” Lifting the entire soft tissue layer as a unified block results in a authentic-appearing and more durable outcome. It also means that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the injectable harmed my face. I regret ever using it. If I had avoided the filler, I don’t think I would be where I’m at currently.”

If dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face becomes somewhat fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though studies into the topic is preliminary, warnings on injectables’ potential impact on the body’s drainage have been released, and further research initiated. An esteemed face specialist, speaking anonymously, says he would never use fillers in a patient because of the dangers they present. “A lot of doctors don’t want to talk about this, because the manufacturers who produce filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a face and neck lift could be what she required 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 clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon recommended that a facelift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d arrived alone in the country, she opted to include a mouth enhancement. “Then he said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|