‘My Eyes Were So Swollen I Was Unable to Even Unseal Them’

Onemanda Preisinger feels anxious about her child’s impending 13th birthday celebration. It’s not due to the usual causes associated with a house full of clamorous adolescent kids, but because it’s the first time she will debut her recently altered face to friends and relatives. “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 Southern Florida.

How she looks is, admittedly, a little startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of people electing to have a rhytidectomy in their 20s and 30s – well over a decade before most doctors’ usual candidate age of forty to sixty. (Although most surgeons are eager to highlight the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe people opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue called the SMAS. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that is what loosens and sags and pulls the dermis downward with it.”

You risk operating on individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels expands the face and leads to looseness in the skin – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of new, famous-figure-promoted operative methods are attracting a different type of customer towards this major operation. Statistics indicate an 8% increase in facelifts over the last year in the UK; while a survey found that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails lifting the SMAS, the comprehensive lift releases the underlying structures underneath, enabling surgeons to reshape the face by moving the deeper tissue, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the skin because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin comes with it as a passenger.” Lifting the whole facial structure as a single unit results in a authentic-appearing and more durable result. It also means 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 contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at least not at the thirty years old. But years of using injectable gels in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the injectable harmed my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

Whether dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Research have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘pillow face’ is also the fact that to some extent, the face gets slightly fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Though research into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies announced. One highly regarded face specialist, commenting anonymously, says he would never use injectables in a patient because of the dangers they present. “A lot of doctors avoid talk about this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she had to keep replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a face and neck lift could be what she required to exit the cycle of treatments. Two years later, she found herself choosing between a selection of recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – 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 cheek lift and a jawline surgery. The eve of her operation, one day after she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|