For decades, facelift patients faced a frustrating tradeoff. A surgeon could deliver a younger look or a natural one, but rarely both at once. The tightened, wind-swept appearance became a punchline, an unmistakable sign that work had been done. Dr. Andrew Jacono, a facial plastic surgeon based in New York, built his reputation on rejecting that tradeoff entirely.
Rather than pulling skin taut over the same underlying structure, Dr. Andrew Jacono developed a method that repositions the deeper layers of the face. His extended deep-plane facelift keeps skin, muscle and fat connected as one unit during surgery, addressing the actual cause of an aged appearance instead of masking it at the surface.
Moving Beneath the Surface
Conventional facelifts operate on the superficial musculoaponeurotic system from above, tightening it like fabric stretched over a frame. Dr. Andrew Jacono instead works underneath that layer, releasing the ligaments that hold facial tissue in a descended position. The midface, jawline and neck can then move vertically back toward their original placement.
The approach dates to the early 2000s, with Dr. Jacono publishing his first peer-reviewed outcomes study in the Aesthetic Surgery Journal in 2011, drawing on data from 153 patients. That research helped establish the technique among peers who had grown accustomed to surface-level tightening as the default.
Patients describe the outcome as looking like a rested version of themselves. Incisions run roughly a third the length of those used in older techniques and sit hidden behind the ear or along the hairline, letting patients wear their hair up without evidence of surgery.
Durability adds another layer to the technique’s appeal. Because the correction happens at the structural level rather than at the skin’s surface, results tend to hold for 12 to 15 years, nearly double the span typically reported for standard SMAS facelifts. Early outcomes research also pointed to lower complication rates than older approaches, including a hematoma rate near 1.9 percent.
That combination of subtlety and durability is why surgeons increasingly point to Dr. Jacono’s work when describing where facelift technique now stands. What began as one surgeon’s departure from convention has grown into a documented method taught at conferences and detailed in medical literature, changing expectations for what a facelift can achieve without looking like one. Visit this page for more information.
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