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

Onemanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical reasons associated with a house full of loud preteen kids, but since it’s the first time she will debut her new face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not the way I appear,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a little startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I couldn’t even open my eyes. That indicates swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a rising count of individuals choosing to have a rhytidectomy in their 20s and 30s – well over a ten years before most doctors’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the tissues in the face that begin to droop as we grow older. “Human faces are built a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue called the SMAS. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what loosens and sags and drags the dermis down with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when overuse of injectable gels expands the face and leads to looseness in the dermis – alongside the widespread use of slimming medications, low-cost surgical travel, and the advancement of new, famous-figure-promoted surgical techniques are attracting a different type of patient towards this major operation. Statistics indicate an 8% increase in facial lifts over the past 12 months in the UK; 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.

“Patients are now requesting to appear as the optimal form of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional facelift involves lifting the SMAS, the comprehensive lift loosens the facial ligaments underneath, enabling doctors to reshape the face by moving the underlying layers, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing 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 “enhancement” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the age of 30. But long-term using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler ruined my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have shown that they seldom completely dissolve,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the fact that to some extent, the face becomes somewhat waterlogged because its capacity to drain lymphatic fluid has been reduced.” Although studies into the topic is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and further research announced. One highly regarded face specialist, commenting anonymously, mentioned he would never use fillers in a patient because of the risks they pose. “A lot of doctors don’t want to talk about this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a face and neck lift could be what she required to finally step off the injectable hamster wheel. Two years later, she ended up selecting from a list of recommended hotels in the city, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facelift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her operation, one day after she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, plus a three-day|