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

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday party. It’s not due to the typical causes related to a house full of loud adolescent children, but because it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” states the thirty-year-old property agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – look is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even unseal my eyes. That indicates swollen I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a growing number of individuals choosing to have a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” states London-based 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 observe people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are built a bit like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and pulls the skin down with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers expands the face and causes laxity in the dermis – combined with the widespread use of slimming medications, cut-price medical tourism, and the development of new, famous-figure-promoted operative methods are driving a new kind of patient towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a study revealed that the portion of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are now requesting to appear as the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves elevating the SMAS, the comprehensive lift releases the facial ligaments beneath it, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Lifting the entire soft tissue layer 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 primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned 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 “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the filler harmed my face. I wish I had never using it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face becomes slightly waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though studies into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been released, and further research initiated. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would never use fillers in a patient because of the dangers they present. “A lot of doctors don’t want to discussing this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue 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 proposed that a face and neck lift might be what she needed to exit the injectable hamster wheel. Two years later, she found herself choosing between a selection of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the correct option for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her operation, one day after she’d touched down alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|