Most facelifts address what gravity does to skin. Dr. Andrew Jacono‘s extended deep-plane approach addresses what gravity does to the underlying structures that hold the face together a distinction that explains why his results tend to outlast conventional procedures by a significant margin.
Surface Versus Structure
Standard SMAS facelifts separate the skin from the deeper tissue layer, then tighten the skin independently. That approach produces results that typically hold for six to eight years before the tissue descends again. The Minimal Access Deep-Plane Extended facelift that Dr. Andrew Jacono developed operates beneath the SMAS, lifting skin, muscle, and fat as one cohesive unit rather than treating the surface in isolation. Incisions run roughly one-third the length of traditional facelifts, positioned behind the ear and along the hairline small enough that patients can wear their hair pulled back without visible scarring, which Dr. Andrew Jacono describes as a “ponytail-friendly” outcome.
By releasing the four major retaining ligaments that tether facial tissue to bone, the technique allows the midface fat pads, jowls, and neck tissue to migrate back toward their original positions vertically, not diagonally toward the ears as most surface lifts achieve.
Published Outcomes and Peer Recognition
The clinical record supporting this approach is extensive. Dr. Jacono first published outcomes data in 2011, covering 153 patients with complication rates below the field’s average. Later research confirmed that deep-plane techniques carry lower facial nerve injury risk than superficial methods, because dissection under this layer better preserves blood supply and anatomical relationships. Town & Country noted that Dr. Jacono keeps skin, muscle, and fat as one unit when repositioning the biomechanical key to avoiding the stretched look that marks older facelift methods. Fashion designer Marc Jacobs publicly credited the results as natural-looking after his own surgery with Dr. Jacono in 2021. See related link for additional information.
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