‘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. Not for the usual causes related to a house full of clamorous adolescent kids, but since it’s the first time she will debut her recently altered face to acquaintances and relatives. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not the way I appear,’” states the 30-year-old real estate agent from south Florida.

How she looks is, well, a little surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to me via online call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to undergo a facelift in their twenties and thirties – significantly before a ten years before most doctors’ typical patient age range of forty to sixty. (Although most surgeons are eager to highlight the industry edict of: “We address genetics, not years.”) “I have 28-year-olds asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are built a bit like layers of an onion,” 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 soft tissue skeleton of the face. And that’s what causes aging; that is what becomes lax and drags the skin down with it.”

You risk performing surgery on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and causes laxity in the skin – alongside the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of new, celebrity-endorsed operative methods are attracting a new kind of customer towards this major operation. Statistics show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey found that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients are now requesting to appear as the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional facelift involves elevating the superficial layer, the deep plane facelift releases the facial ligaments beneath it, allowing doctors to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a passenger.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and more durable outcome. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the injectable ruined my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be in this situation right now.”

If dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is additionally the reality that to some extent, the face becomes somewhat fluid-filled because its capacity to drain lymphatic fluid has been diminished.” Though research into the topic is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would never use injectables in a patient because of the risks they pose. “Many doctors don’t want to talk about this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if 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 the state suggested that a face and neck lift could be what she required to exit the injectable hamster wheel. After 24 months, she ended up selecting from a list of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facelift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d arrived solo in the country, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She spent $22,000 (£16,500) for the six-hour operation, plus a three-day|