For decades, facelift patients had to choose between a younger look and a natural one. Traditional techniques stretched skin tight, often leaving behind the stiff, wind-tunnel appearance long associated with cosmetic surgery. Dr. Andrew Jacono, a New York facial plastic surgeon, changed that equation with an approach that rebuilds the face’s underlying architecture instead of just tightening its surface.
A Different Surgical Layer
Dr. Andrew Jacono introduced the extended deep-plane facelift technique in the early 2000s, moving the point of intervention below the superficial musculoaponeurotic system, or SMAS, the tissue layer connecting facial muscles to skin. Conventional facelifts separate skin from underlying tissue and reposition only that surface layer. His method keeps skin, muscle and fat connected as one unit, then releases the facial ligaments holding tissue in place before repositioning the midface, jawline and neck vertically to restore youthful contours.
That vertical repositioning restores contours that sag over time rather than masking them with tension. Dr. Jacono published his first peer reviewed study on the technique in Aesthetic Surgery Journal in 2011, detailing outcomes from 153 patients, a paper that gave the approach its early clinical footing among facial plastic surgeons who had grown accustomed to surface level skin tightening as the only option available.
Data Behind the Technique
Clinical results have followed the technique’s rise. Initial studies recorded a 3.9 percent revision rate, an approximately 1.9 percent hematoma rate and a 1.3 percent temporary facial nerve injury rate, figures that sit below industry averages for facelift procedures. Later research found that deep-plane methods carry a lower chance of nerve injury than superficial facelifts because the dissection preserves anatomical relationships and blood supply. Patients now describe the outcome as looking like a refreshed version of themselves, a result Dr. Andrew Jacono attributes to restoring anatomical position rather than pulling skin taut. He now performs roughly 250 of these procedures each year at his Manhattan practice.
The approach has also drawn recognition well beyond routine safety statistics. Dr. Jacono has lectured at international plastic surgery conferences and trained other surgeons in the method, helping extend a safety record built in one Manhattan practice to operating rooms elsewhere. Results reportedly last 12 to 15 years, nearly double the span of a standard SMAS facelift, adding durability to a technique already distinguished by its lower complication figures. Visit this page for more information.
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