‘I Couldn’t Even Unseal My Eyes. That’s The Extent of the Swelling I Was’

Onemanda Preisinger feels anxious about her child’s impending 13th birthday celebration. It’s not due to the typical causes associated with a home packed of clamorous preteen children, but since it’s the initial occasion she will debut her new face to friends and extended family. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, admittedly, a little surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via video 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.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is among a rising count of people electing to undergo a facelift in their twenties and thirties – well over a ten years prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “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 Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what ages us; that is what becomes lax and drags the dermis down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and causes looseness in the skin – alongside the widespread use of slimming medications, cut-price surgical travel, and the advancement of novel, famous-figure-promoted surgical techniques are driving a new kind of patient towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the past 12 months in the UK; while a study revealed that the percentage of younger facelift patients is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves lifting the SMAS, the deep plane facelift releases the underlying structures beneath it, allowing doctors to restructure the face by repositioning 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 going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and more durable result. It additionally implies that the surgery is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” 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 effort at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the injectable harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

If injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the reality that in a sense, the face gets somewhat waterlogged because its ability to drain bodily fluid has been reduced.” Although research into the topic is early-stage, warnings on injectables’ possible effects on the lymphatic system have been released, and additional studies initiated. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would avoid using fillers in a client because of the dangers they pose. “Many doctors avoid talk about this, because the companies who make filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she had to keep adding more – particularly when it began moving to different areas of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a list of suggested accommodations in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon recommended that a facial lift was the correct option for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The eve of her operation, one day after she’d arrived alone in Turkey, she opted to include a lip lift. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|