‘My Eyes Were So Swollen I Couldn’t Even Open Them’

Onemanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the typical causes related to a house full of loud adolescent children, but because it’s the first time she will reveal 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 how I look,’” says the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – look is the result of half a dozen cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional 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 house. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade prior to most doctors’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the ligaments 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 facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that is what becomes lax and drags the dermis down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and leads to looseness in the dermis – alongside the common adoption of slimming medications, cut-price surgical travel, and the development of new, famous-figure-promoted operative methods are attracting a new kind of patient towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the UK; while a survey found that the portion of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are asking now to appear as the best version of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves elevating the superficial layer, the deep plane facelift releases the facial ligaments beneath it, enabling doctors to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re going below, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Lifting the whole facial structure as a single unit results in a more natural-looking and longer-lasting result. It additionally implies that the surgery is not just being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the thirty years old. But years of using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she says. “I did it because the filler harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

If dermal fillers completely disappear has long been a debated topic in the cosmetic field. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face gets somewhat fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Although studies into the area is early-stage, warnings on dermal fillers’ possible effects on the body’s drainage have been released, and additional studies initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using injectables in a patient because of the risks they pose. “Many surgeons don’t want to discussing this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she required to finally step off the cycle of treatments. Two years later, she found herself choosing between a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facelift was the right solution for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d arrived alone in the country, she opted to include a lip lift. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we remove some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|