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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the usual causes related to a home packed of loud adolescent children, but because it’s the initial occasion she will debut her new face to acquaintances and relatives. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not the way I look,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon 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 indicates swollen I was,” she tells me via video call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a rising count of individuals choosing to have a facelift in their twenties and thirties – significantly before a decade before most doctors’ typical patient age range of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Human faces are built a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and drags the dermis downward with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers stretches the face and causes looseness in the skin – alongside the widespread use of slimming medications, low-cost surgical travel, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of patient towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the UK; while a survey revealed that the portion of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“People are now requesting to appear as the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails lifting the superficial layer, the comprehensive lift loosens the facial ligaments underneath, allowing surgeons to reshape the face by repositioning the underlying layers, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing tension on the dermis because we’re targeting deeper, 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 adjusted. The skin follows along as a passenger.” Elevating the whole facial structure as a single unit results in a more natural-looking and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the thirty years old. But long-term using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the injectable ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

If injectable substances ever fully dissolve 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 obstruct lymphatic channels. A contributing factor to what we term ‘pillow face’ is also the reality that in a sense, the face gets somewhat waterlogged because its capacity to drain bodily fluid has been reduced.” Although studies into the area is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been issued, and further research initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using fillers in a client because of the risks they present. “Many doctors avoid talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she had to keep replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight 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 list of suggested accommodations in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facial lift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, plus a three-day|