For most of the twentieth century, a facelift meant trading one problem for another. Patients walked away looking younger in years but obviously surgical in appearance, with pulled skin and unnatural tension that announced the procedure to everyone around them. A New York facial plastic surgeon changed the calculus of that equation entirely, building a technique that prioritizes anatomical restoration over surface manipulation.
Dr. Andrew Jacono introduced the extended deep-plane facelift in the early 2000s, a method that departs fundamentally from how conventional facelifts work. Traditional procedures isolate the skin from the underlying tissue layers and reposition only the outermost surface. The result is tightness without structural support, which is why those results tend to fade quickly and often look artificial.
A Different Approach to Facial Anatomy
The extended deep-plane technique operates beneath the superficial musculoaponeurotic system, commonly referred to as the SMAS, which is the layer of tissue that connects facial muscles to the overlying skin. Rather than tightening this layer from above as standard facelifts do, Dr. Andrew Jacono works underneath it. He releases key facial ligaments that anchor tissue in a descended position, then repositions the midface, jawline, and neck structures vertically to restore contours that reflect a younger version of the patient.
Because the skin, muscle, and fat move together as a connected unit rather than being separated and manipulated independently, the repositioning looks natural. Patients describe the outcome as looking like refreshed versions of themselves. The incisions are also notably shorter, measuring roughly one-third the length of traditional facelift incisions, and are placed behind the ear or along the hairline where they remain hidden.
Outcomes Backed by Research
Dr. Jacono published his first peer-reviewed study on the technique in Aesthetic Surgery Journal in 2011, drawing on outcomes from 153 patients. Complication rates were notably low: a 3.9% revision rate, approximately 1.9% hematoma rate, and 1.3% temporary facial nerve injury, figures that fall well below industry averages for facelift procedures. Results from his extended deep-plane method last 12 to 15 years, roughly twice the duration of standard SMAS facelifts. This longevity comes from addressing structural changes at their source rather than treating only visible symptoms on the skin’s surface. Visit this page, for related information.
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