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

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. It’s not due to the usual reasons related to a home packed of clamorous adolescent children, but since it’s the initial occasion she will showcase her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not the way I look,’” states the thirty-year-old property agent from south Florida.

How she looks is, well, a little startling – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of people electing to undergo a facelift in their 20s and 30s – well over a ten years before most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that begin to droop as we age. “Our faces are built a bit like onion layers,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and pulls the dermis down with it.”

You risk operating on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and causes laxity in the skin – combined with the widespread use of slimming medications, low-cost surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a different type of customer towards this major operation. Reports indicate an eight percent rise in facelifts over the past 12 months in the UK; while a survey found that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged 35-55.

“People are asking now to look like the best version of themselves and obviously the techniques are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy entails lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, enabling doctors to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled look occasionally caused by older methods. “We avoid placing stress on the skin because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers 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 wanted to look youthful,” she clarifies. “I did it because the filler harmed my face. I regret ever done it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

If dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Research have shown that they seldom completely dissolve,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Although research into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, commenting anonymously, says he would never use fillers in a client because of the risks they pose. “Many doctors don’t want to discussing this, because the companies who make injectables can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state suggested that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her surgery, one day after she’d touched down alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we remove some cheek fat, it will contour your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|