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

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday party. Not for the typical reasons associated with a home packed of clamorous adolescent kids, but because it’s the initial occasion she will showcase her recently altered face to friends and relatives. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not how I look,’” states the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a little startling – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of people electing to have a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are structured a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and drags the skin down with it.”

You risk operating on individuals that have underlying problems. It’s not advisable 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 leads to looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are attracting a different type of customer towards this major operation. Reports show an 8% increase in facelifts over the last year in the United Kingdom; while a study found that the percentage of youthful candidates is increasing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“People are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails lifting the SMAS, the comprehensive lift loosens the facial ligaments underneath, allowing surgeons to restructure the face by moving the deeper tissue, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Lifting the entire soft tissue layer 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 describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I did it because the filler ruined my face. I regret ever done it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

If injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the fact that in a sense, the face becomes slightly fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though studies into the topic is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would never use fillers in a client because of the risks they present. “Many surgeons don’t want to talk about this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery could be what she required to exit the injectable hamster wheel. Two years later, she ended up choosing between a list of recommended hotels in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down solo in the country, she opted to include a lip lift. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|