Revolutionary technique transforms facial rejuvenation by addressing deeper structural layers for natural, long-lasting results
The facelift has come a long way from the windswept, overly tight appearances that once defined cosmetic surgery. Dr. Andrew Jacono pioneered a technique in the early 2000s that fundamentally changed how surgeons approach facial rejuvenation. His Minimal Access Deep-Plane Extended (MADE) facelift doesn’t just pull skin tighter—it rebuilds the face’s underlying architecture.
Traditional facelifts separate skin from muscle, then pull the skin upward and backward to smooth wrinkles. The approach often creates that telltale “done” look. Dr. Andrew Jacono’s extended deep-plane facelift takes a different path. He lifts the skin, muscle, and fat together as one cohesive unit, preserving the natural connections between tissue layers. Town & Country described how “Jacono keeps the skin, muscle, and fat as one unit” to achieve results that look refreshed rather than reconstructed.
The Science Behind Deeper Layers
The innovation lies in where Dr. Andrew Jacono operates. He works beneath the superficial musculoaponeurotic system (SMAS)—a layer of tissue that connects facial muscles to skin. Traditional lifts tighten this layer from above. The extended deep-plane approach releases key facial ligaments that hold tissue down, allowing Dr. Andrew Jacono to reposition the midface, jawline, and neck fat pads vertically to their youthful positions.
Dr. Andrew Jacono first published his technique in Aesthetic Surgery Journal in 2011, detailing results from 153 patients. The data told a compelling story: only a 3.9% revision rate, approximately 1.9% hematoma rate, and 1.3% temporary facial nerve injury. These complication rates fell well below industry averages for facelift procedures.
The longevity sets the extended deep-plane facelift apart from alternatives. Dr. Andrew Jacono reports results lasting 12 to 15 years—roughly twice as long as standard SMAS facelifts. The deeper tissue support maintains its position longer because it addresses the root cause of aging rather than surface symptoms.
Minimal Scars, Maximum Impact
Dr. Andrew Jacono calls his approach “ponytail-friendly” because incisions measure about one-third the length of traditional facelift incisions. He tucks them behind the ear and along the hairline where they remain virtually invisible. Patients can wear their hair up without revealing evidence of surgery—a crucial consideration for those seeking discretion.
The technique also reduces risks. Studies show the deep-plane approach carries lower risk of facial nerve injury compared to superficial facelifts. When surgeons preserve anatomical relationships and blood supply by keeping tissue layers together, they protect delicate nerves that control facial expression.
Celebrity Endorsements and Peer Recognition
Fashion designer Marc Jacobs went public about his choice of Dr. Andrew Jacono in 2021. Vogue covered the revelation, quoting the designer’s satisfaction with results that avoided the “where you can’t fix things” pitfall of overdone surgery. Even plastic surgeons seek out Dr. Andrew Jacono’s expertise. Dr. Paul Nassif, star of the reality show Botched, traveled from Beverly Hills to New York for his own extended deep-plane facelift, later telling media he wanted to look like “a younger version of himself.”
Dr. Andrew Jacono performs approximately 400 deep-plane facelifts annually, a volume far exceeding typical surgical practices. This high case load allows continuous refinement of his technique. He has shared his methodology through master courses and international lectures, training surgeons worldwide in “The Jacono Method.”
His 2021 medical textbook, The Art and Science of Extended Deep Plane Facelifting, synthesizes insights from over 2,000 facelift procedures. The publication serves as a technical guide for surgeons seeking to master the approach that has influenced facial plastic surgery globally.
The extended deep-plane facelift represents more than technical innovation. Dr. Andrew Jacono’s method acknowledges that faces age in three dimensions, not just on the surface. Tissue descends and deflates over time. Addressing those changes at their source—in the deeper structural layers—produces results that withstand both scrutiny and time. Patients walk away looking like themselves, just rested and rejuvenated, which may be the highest compliment any facelift technique can receive.
