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

Onemanda Preisinger experiences worry about her child’s impending 13th birthday party. It’s not due to the typical causes related to a house full of clamorous preteen children, but because it’s the first time she will reveal her new face to acquaintances and extended family. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not how I look,’” says the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a little startling – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, temporary – appearance is the outcome of half a dozen aesthetic surgeries, such as an minimally invasive 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 couldn’t even open my eyes. That indicates swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a growing number of people electing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before typical surgeons’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” says based in London 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 bit concerned when I see people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Our faces are built a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and drags the dermis down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when overuse of injectable gels expands the face and leads to looseness in the skin – combined with the widespread use of slimming medications, cut-price surgical travel, and the development of novel, celebrity-endorsed operative methods are driving a different type of customer towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study found that the portion of youthful candidates is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails elevating the SMAS, the deep plane facelift releases the facial ligaments underneath, enabling doctors to restructure the face by repositioning the underlying layers, and preventing the taut, pulled look sometimes wrought by older methods. “We avoid placing tension 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 follows along as a passenger.” Lifting the whole facial structure as a single unit allows for a more natural-looking and more durable outcome. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I underwent it because the filler ruined my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

Whether injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘pillow face’ is also the reality that in a sense, the face gets slightly waterlogged because its ability to drain lymphatic fluid has been reduced.” Although research into the topic is early-stage, warnings on injectables’ possible effects on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, commenting on the condition of anonymity, says he would avoid using fillers in a patient because of the dangers they present. “A lot of doctors don’t want to talk about this, because the companies who make filler can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue adding more – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in the state suggested that a face and neck lift might be what she needed to finally step off the cycle of treatments. After 24 months, she found herself selecting from a selection of suggested accommodations in the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facelift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the half-day operation, including a three-day|