‘I Wasn’t Able to Even Unseal My Eyes. That’s How Swollen I Was’

Onemanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. Not for the usual reasons related to a house full of loud preteen kids, but because it’s the first time she will showcase her recently altered face to friends and extended family. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old real estate agent from south Florida.

How she looks is, well, a somewhat startling – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the result of half a dozen aesthetic surgeries, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of individuals choosing to have a rhytidectomy in their 20s and 30s – significantly before a ten years before most doctors’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we grow older. “Human faces are built a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the SMAS. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what loosens and sags and pulls the dermis down with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when overuse of injectable gels stretches the face and leads to looseness in the dermis – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are attracting a new kind of patient towards this invasive surgery. Reports show an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of youthful candidates is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the optimal form of themselves and naturally the techniques are following,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails lifting the superficial layer, the deep plane facelift loosens the facial ligaments underneath, enabling doctors to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched appearance occasionally caused by older methods. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We receive numerous requests from patients 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 hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the injectable harmed my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have shown that they seldom completely dissolve,” says Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the reality that to some extent, the face becomes somewhat waterlogged because its ability to remove bodily fluid has been reduced.” Although research into the topic is early-stage, warnings on injectables’ possible effects on the lymphatic system have been issued, and further research announced. An esteemed face specialist, commenting anonymously, mentioned he would never use injectables in a patient because of the risks they present. “A lot of surgeons don’t want to talk about this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – especially as it started to migrate to other parts 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 injectable hamster wheel. After 24 months, she ended up choosing between a selection of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facelift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The eve of her surgery, 24 hours post she’d arrived solo in the country, she decided to add a mouth enhancement. “Then he stated, ‘We will lift the under-eye bags.’ He added, ‘I think if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|