‘I Wasn’t Able to Even Open My Eyes. That’s How Swollen I Was’

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. It’s not due to the typical causes related to a house full of loud adolescent kids, but since it’s the first time she will showcase her new face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘For your information, this is not how I look,’” states the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My spouse teared up when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of individuals choosing to undergo a rhytidectomy in their 20s and 30s – well over a decade prior to typical surgeons’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facial lifts,” states London-based cosmetic 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 see people choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Our faces are structured a bit like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that’s what ages us; that is what becomes lax and drags the skin downward with it.”

You risk operating on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and causes laxity in the skin – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of customer towards this major operation. Statistics show an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey found that the portion of youthful candidates is growing, with 32% of facelifts now performed on 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,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, enabling surgeons to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a authentic-appearing and more durable result. It also means that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But years of using injectable gels in an attempt at “facial balancing” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the injectable ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

If dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies 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 term ‘pillow face’ is also the reality that in a sense, the face becomes somewhat fluid-filled because its ability to remove bodily fluid has been reduced.” Though research into the area is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and further research announced. An esteemed face specialist, speaking anonymously, mentioned he would avoid using injectables in a patient because of the risks they pose. “A lot of doctors avoid discussing this, because the manufacturers who produce filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – especially as it began moving to different areas of her face. She was just 28 when a local plastic surgeon in the state proposed that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. Two years later, she ended up selecting from a list of suggested accommodations in the city, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor recommended that a facelift was the correct option for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, 24 hours post she’d arrived solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|