Surgical techniques often stay with the surgeons who invent them. The extended deep-plane facelift took a different path. Dr. Andrew Jacono, a dual board-certified facial plastic surgeon in New York, has delivered master lectures at more than 100 international conferences, teaching the method to surgeons across the globe.
His 2021 medical textbook gathered insights from over 2,000 facelift procedures. The book set technical standards that other surgeons now follow, and the approach it describes has been widely adopted.
From Single Practice to Common Method
Jacono introduced the Minimal Access Deep-Plane Extended (MADE) facelift in the early 2000s. Publication came in 2011, when Aesthetic Surgery Journal printed his account of 153 patients. Initial clinical data showed a 3.9% revision rate, approximately 1.9% hematoma rate, and 1.3% temporary facial nerve injury, all below industry averages.
A 2019 refinement followed, adding modifications for the jawline and volume in the lower face. Dr. Andrew Jacono quantified those changes with measurements such as the “mandibular defining line,” which tracks improvements in jawline contour.
What Other Surgeons Are Learning
The core idea is anatomical. A standard facelift detaches skin from the SMAS and tightens it, leaving deeper structures alone. The MADE facelift operates beneath that layer, moving skin, muscle, and fat as one. Four ligaments anchoring tissue to bone are released so descended fat pads in the midface, jawline, and neck can rise vertically. Incisions are about one-third the usual length and stay hidden behind the ear and along the hairline. The payoff is durability: results can last roughly twice as long as a standard SMAS facelift, often beyond a decade.
Interest has reached the profession itself. Plastic surgeon Dr. Paul Nassif traveled from Beverly Hills to New York for the procedure. Fashion designer Marc Jacobs also had the surgery, telling Vogue in 2021 that the results looked natural. Meanwhile, Dr. Andrew Jacono continues to perform about 250 extended deep-plane facelifts each year at his Manhattan practice, a caseload that keeps refining his sense of which ligaments to release and which lifting vectors work best. See related link for more information.
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