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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the typical reasons associated with a house full of loud preteen kids, but because it’s the first time she will showcase her new face to acquaintances and relatives. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not how I appear,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – look is the result of six aesthetic surgeries, including an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, last month. “My spouse teared up when he viewed me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like 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 rhytidectomy in their twenties and thirties – significantly before a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are built a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what becomes lax and drags the dermis down with it.”

You risk operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of dermal fillers stretches the face and leads to laxity in the skin – alongside the common adoption of slimming medications, cut-price medical tourism, and the advancement of novel, famous-figure-promoted operative methods are attracting a different type of customer towards this invasive surgery. Reports show an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey revealed that the portion of youthful candidates is increasing, with one-third of procedures now conducted for patients aged 35-55.

“People are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy entails elevating the SMAS, the deep plane facelift loosens the facial ligaments beneath it, enabling doctors to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled appearance occasionally caused by older methods. “We avoid placing stress on the skin because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – 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,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the filler ruined my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be where I’m at right now.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face gets somewhat waterlogged because its ability to drain bodily fluid has been diminished.” Though research into the topic is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies announced. One highly regarded face specialist, commenting anonymously, mentioned he would avoid using fillers in a client because of the risks they present. “A lot of surgeons avoid discussing 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 raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she had to keep adding more – especially as it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she required to exit the injectable hamster wheel. After 24 months, she found herself selecting from a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon recommended that a facial lift was the right solution for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|