‘I Couldn’t Even Open My Eyes. That’s How Swollen I Was’

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. Not for the usual reasons associated with a home packed of clamorous adolescent children, but because it’s the first time she will debut her recently altered face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat startling – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of people electing to have a rhytidectomy in their 20s and 30s – significantly before a decade prior to typical surgeons’ usual candidate age of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that start to sag as we grow older. “Human faces are built a bit like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that’s what loosens and sags and pulls the skin down with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an conscientious surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers stretches the face and leads to laxity in the dermis – combined with the widespread use of slimming medications, low-cost surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are driving a different type of patient towards this major operation. Statistics indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a study revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on patients aged 35-55.

“People are asking now to look like the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy entails elevating the SMAS, the deep plane facelift releases the underlying structures underneath, allowing doctors to reshape the face by moving the underlying layers, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The skin follows along as a passenger.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting result. It also means 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 “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler ruined my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

If dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘pillow face’ is also the fact that to some extent, the face gets somewhat fluid-filled because its capacity to remove bodily fluid has been reduced.” Though studies into the topic is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use fillers in a patient because of the dangers they pose. “Many doctors don’t want to discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she had to keep replenishing it – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift could be what she needed to exit the cycle of treatments. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facelift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a neck lift. The eve of her surgery, one day after she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|