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

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

Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of six aesthetic surgeries, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the first time because I wasn’t able to even open 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 hurting. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of people electing to have a facelift in their twenties and thirties – significantly before a ten years prior to typical surgeons’ usual candidate age of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We treat genetics, not age.”) “I have 28-year-olds requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that start to sag as we age. “Human faces are built a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that is what causes aging; that’s what becomes lax and pulls 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 follow

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and leads to laxity in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a different type of customer towards this major operation. Reports indicate an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for patients aged 35-55.

“People are now requesting to look like the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves lifting the SMAS, the deep plane facelift releases the facial ligaments beneath it, allowing doctors to reshape the face by repositioning the underlying layers, and preventing the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the injectable ruined my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

Whether dermal fillers completely disappear has historically been a point of contention in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the reality that to some extent, the face becomes somewhat waterlogged because its ability to drain bodily fluid has been diminished.” Although research into the topic is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would never use injectables in a client because of the dangers they pose. “Many doctors don’t want to talk about this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed 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 the state proposed that a face and neck lift could be what she required to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a list of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facial lift was the correct option for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d arrived solo in the country, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|