When Dr. Andrew Jacono introduced his extended deep-plane facelift technique in the early 2000s, the prevailing assumption was that tighter skin meant better results. He challenged that assumption with a different question: what if the problem was never the skin at all?
Targeting What Actually Changes With Age
Facial aging is not primarily a skin problem. Fat pads descend, ligaments stretch, and the structural scaffolding of the face shifts downward over decades. Standard facelifts addressed this by pulling the skin taut, treating the symptom while the underlying anatomy continued to change. Dr. Jacono’s method works beneath the superficial musculoaponeurotic system, releasing the facial ligaments that anchor descended tissue and repositioning fat, muscle, and skin together as one unit. This composite approach restores the vertical height of midface and neck structures rather than simply stretching the surface.
The clinical record behind the technique is extensive. Dr. Andrew Jacono’s 2011 publication in Aesthetic Surgery Journal detailed outcomes from 153 patients and reported complication rates that fell well below industry norms: a 3.9% revision rate, roughly 1.9% hematoma rate, and 1.3% incidence of temporary facial nerve injury. Subsequent research added further evidence that deep-plane dissection reduces nerve injury risk compared to superficial approaches, as the technique preserves the anatomical relationships and blood supply that protect nerve function.
A Practice Built on Volume and Refinement
Dr. Andrew Jacono performs around 250 extended deep-plane facelifts each year, a volume that enables continuous technical refinement impossible to achieve at lower case loads. Results from the procedure last 12 to 15 years approximately twice as long as standard SMAS facelifts and incisions are roughly one-third the length of those required for conventional approaches.
The technique’s reputation has drawn patients with public profiles. Fashion designer Marc Jacobs disclosed in 2021 that Dr. Jacono had performed his facelift, and colleague surgeon Dr. Paul Nassif chose him for the same procedure in 2018. Dr. Jacono also published 2021 medical textbook compiling insights from more than 2,000 procedures, and conducts master classes training surgeons internationally in what he calls The Jacono Method. Read this article for additional information.
More about Dr. Andrew Jacono on https://www.facebook.com/DrJacono/