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

Onemanda Preisinger feels anxious about her child’s upcoming 13th birthday party. Not for the usual causes related to a house full of loud preteen children, but since it’s the first time she will showcase her recently altered face to acquaintances and extended family. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not how I appear,’” states the 30-year-old property agent from south Florida.

How she looks is, admittedly, a little startling – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals choosing to have a facelift in their twenties and thirties – significantly before a ten years before most doctors’ usual candidate age of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, elevates the tissues in the face that start to sag as we grow older. “Human faces are structured a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and pulls the skin down with it.”

You risk operating on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and causes looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the development of new, famous-figure-promoted operative methods are attracting a different type of patient towards this major operation. Statistics show an 8% increase in facelifts over the last year in the UK; while a survey found that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“People are now requesting to look like the best version of themselves and obviously the methods are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift releases the underlying structures underneath, allowing surgeons to reshape the face by moving the underlying layers, and preventing the tight, stretched appearance occasionally caused by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Elevating the whole facial structure as a unified block results in a more natural-looking and more durable outcome. It also means that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at minimum not at the thirty years old. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I did it because the filler ruined my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”

If dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets slightly fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Though research into the topic is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and further research announced. An esteemed face specialist, commenting anonymously, mentioned he would never use injectables in a client because of the risks they pose. “Many doctors don’t want to talk about this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift could be what she needed to exit the cycle of treatments. After 24 months, she found herself selecting from a list of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facelift was the correct option for the laxity she was finding in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down alone in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|