‘I Couldn’t Even Open My Eyes. That’s How Swollen I Was’

Onemanda Preisinger feels anxious about her child’s upcoming 13th birthday party. Not for the typical reasons associated with a house full of clamorous adolescent children, but because it’s the first time she will showcase her new face to acquaintances and extended family. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of people choosing to have a facelift in their 20s and 30s – significantly before a decade before most doctors’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a facelift, lifts the ligaments in the face that start to sag as we grow older. “Human faces are structured a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and drags the dermis downward with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and causes laxity in the dermis – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, famous-figure-promoted surgical techniques are attracting a different type of patient towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the past 12 months in the UK; while a survey revealed that the percentage of youthful candidates is growing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are asking now to appear as the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift entails elevating the superficial layer, the comprehensive lift loosens the underlying structures beneath it, enabling doctors to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and more durable result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the filler ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

If dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the fact that to some extent, the face gets somewhat waterlogged because its ability to remove lymphatic fluid has been diminished.” Although research into the area is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies announced. One highly regarded face specialist, commenting on the condition of anonymity, says he would never use fillers in a patient because of the dangers they pose. “A lot of doctors don’t want to discussing this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she required to exit the cycle of treatments. After 24 months, she ended up selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her doctor advised her that a facial lift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d arrived alone in the country, she opted to include a mouth enhancement. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|