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

Onemanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the usual reasons associated with a home packed of loud adolescent children, but because it’s the initial occasion she will reveal her recently altered face to friends and extended family. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not the way I look,’” says the 30-year-old property agent from south Florida.

Her appearance is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via online call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of individuals choosing to have a rhytidectomy in their twenties and thirties – significantly before a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds asking for 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 major surgery, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that start to sag as we age. “Our faces are built a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s 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 conscientious surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and leads to looseness in the dermis – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the advancement of new, celebrity-endorsed surgical techniques are driving a new kind of customer towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a study revealed that the percentage of youthful candidates is growing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails elevating the superficial layer, the comprehensive lift releases the facial ligaments beneath it, enabling doctors to reshape the face by repositioning the underlying layers, and preventing the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and more durable result. It also means that the surgery is no longer being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” 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 did it because the injectable harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face becomes slightly waterlogged because its capacity to drain lymphatic fluid has been diminished.” Though studies into the topic 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 on the condition of anonymity, says he would avoid using fillers in a client because of the risks they present. “Many surgeons avoid discussing this, because the companies who produce filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – particularly when it began moving to different areas of her face. She was just 28 when a local plastic surgeon in the state suggested that a face and neck lift might be what she required to finally step off the cycle of treatments. After 24 months, she ended up selecting from a list of suggested accommodations in the city, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facelift was the right solution for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d arrived solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|