‘I Wasn’t Able to Even Open My Eyes. That’s How Swollen I Was’

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual reasons associated with a house full of clamorous preteen children, but because it’s the first time she will reveal her new face to friends and extended family. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not the way I look,’” says the 30-year-old real estate agent from south Florida.

How she looks is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – appearance is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals choosing to undergo a facelift in their twenties and thirties – significantly before a ten years before typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see people opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that start to sag as we age. “Our faces are structured a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that’s what loosens and sags and drags the dermis downward with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of dermal fillers stretches the face and causes laxity in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of new, famous-figure-promoted operative methods are driving a different type of patient towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a survey found that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to look like the best version of themselves and naturally the methods are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves elevating the SMAS, the comprehensive lift loosens the facial ligaments beneath it, allowing doctors to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched look occasionally caused by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting result. It also means that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the injectable ruined my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be in this situation right now.”

If dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Research have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is additionally the reality that to some extent, the face gets somewhat fluid-filled because its ability to drain lymphatic fluid has been diminished.” Although research into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and further research initiated. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would avoid using fillers in a client because of the risks they present. “A lot of surgeons don’t want to talk about this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she had to keep adding more – especially as it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the right solution for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her surgery, one day after she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|