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

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. Not for the usual reasons associated with a house full of clamorous adolescent kids, but since it’s the initial occasion she will showcase her recently altered face to friends and relatives. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not how I appear,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, well, a little surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – look is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last 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’s how swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a rising count of people choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a ten years before most doctors’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have 28-year-olds asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that start to sag as we grow older. “Human faces are built a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, 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’s what loosens and sags and pulls the dermis down with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and causes laxity in the skin – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted operative methods are attracting a new kind of patient towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the last year in the United Kingdom; while a study found that the portion of youthful candidates is increasing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails lifting the SMAS, the deep plane facelift loosens the underlying structures beneath it, enabling doctors to restructure the face by moving the deeper tissue, and avoiding the tight, stretched look sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting outcome. It also means that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I did it because the filler ruined my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

Whether injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the fact that to some extent, the face gets somewhat waterlogged because its ability to remove lymphatic fluid has been diminished.” Though research into the topic is preliminary, warnings on injectables’ possible effects on the body’s drainage have been issued, and further research initiated. An esteemed face specialist, commenting on the condition of anonymity, says he would never use injectables in a patient because of the risks they pose. “A lot of doctors don’t want to discussing this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue adding more – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state proposed 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 selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The eve of her surgery, 24 hours post she’d arrived solo in Turkey, she decided to add a lip lift. “Then he said, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|