For generations, facelift patients accepted a frustrating bargain: visible youth in exchange for an obviously surgical look. The pulled, wind-tunnel effect became so common it was shorthand for cosmetic surgery gone wrong. Dr. Andrew Jacono, a New York facial plastic surgeon, rejected that trade-off and developed a technique that addresses the root cause of facial aging rather than its surface expression.
Rebuilding Structure, Not Pulling Skin
Conventional facelifts separate skin from underlying tissue and reposition only the outer layer, creating telltale tension that signals surgical intervention. Dr. Andrew Jacono‘s extended deep-plane approach keeps skin, muscle, and fat connected as a single composite unit during repositioning. Working beneath the superficial musculoaponeurotic system the tissue layer linking facial muscles to skin he releases key facial ligaments and moves midface, jawline, and neck structures vertically. The result restores youthful contour rather than manufacturing artificial tightness.
Dr. Andrew Jacono published his first peer-reviewed study on the technique in Aesthetic Surgery Journal in 2011, documenting outcomes from 153 patients. The data showed a 3.9% revision rate, approximately a 1.9% hematoma rate, and a 1.3% rate of temporary facial nerve injury all below industry averages. Later research confirmed that deep-plane dissection carries lower facial nerve injury risk than superficial methods because anatomical relationships and blood supply remain intact.
Results That Last and Scars That Stay Hidden
The technique produces results lasting 12 to 15 years, roughly double the longevity of standard SMAS facelifts. Incisions run about one-third the length of traditional approaches and are positioned behind the ear or along the hairline what Dr. Jacono describes as ponytail-friendly outcomes, meaning patients can wear their hair up without revealing surgical evidence.
Dr. Andrew Jacono performs approximately 250 of these procedures annually. Fashion designer Marc Jacobs publicly credited Dr. Jacono with his facelift in 2021, praising the natural appearance. Plastic surgeon Dr. Paul Nassif chose Dr. Jacono for his own procedure in 2018. In the same year as Jacobs’s disclosure, Dr. Jacono published a comprehensive textbook synthesizing lessons from more than 2,000 procedures and has trained surgeons worldwide through master classes and international conferences. Refer to this page, for related information.
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