Facelifts carried a reputation problem for decades. Patients wanted to look younger, but the visible tightness that came with conventional techniques often gave away exactly what had been done, creating a stretched appearance instead of the natural refresh most people actually sought. Dr. Andrew Jacono set out to close that gap. Dr. Andrew Jacono’s solution involved rethinking which layer of tissue a facelift actually corrects. Traditional techniques separate skin from the structure beneath it, then reposition only that thin surface layer, pulling it tight enough to appear younger but often at the cost of a natural look. Dr. Jacono’s extended deep-plane facelift keeps skin, muscle and fat connected as one unit instead.
Correcting Structure Rather Than Surface
Working beneath the superficial musculoaponeurotic system, Dr. Jacono releases the ligaments holding facial tissue in a sagging position and repositions the midface, jawline and neck vertically. That vertical correction of deeper structures, rather than horizontal tension applied to skin, produces the natural quality patients report.
The technique dates to the early 2000s, with Dr. Jacono’s first peer-reviewed study appearing in the Aesthetic Surgery Journal in 2011 based on 153 patients. Incisions measure roughly a third the length used in older methods and remain hidden behind the ear or along the hairline.
Results last 12 to 15 years, nearly twice as long as standard SMAS facelifts, addressing the underlying cause of an aged appearance rather than its surface symptoms.
The clinical data reflects the shift as well. Early studies documented a 3.9 percent revision rate and a temporary facial nerve injury rate of only 1.3 percent, figures that supported wider adoption of the method among surgeons who had previously relied on more conventional, surface-level approaches.
Dr. Jacono has since performed the procedure on thousands of patients, documented its outcomes in a 2021 textbook, and trained surgeons worldwide through master classes and conference lectures, turning what was once a personal innovation into a technique reshaping how the entire field approaches facial rejuvenation. Read this article for additional information.
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