Patients who undergo facelift surgery consistently report one priority above all others: they want to look like themselves, not like someone who has had surgery. For decades, that goal was difficult to achieve. Dr. Andrew Jacono‘s extended deep-plane facelift changed the calculus by abandoning the skin-tension model that made the surgical look so recognizable.
Why Skin Tension Looks Unnatural
The stretched appearance associated with facelift surgery comes from positioning: when only the skin is repositioned and tightened, the underlying tissue hasn’t moved. The face looks pulled because it is. Dr. Andrew Jacono’s technique begins at a deeper anatomical level, beneath the superficial musculoaponeurotic system. He releases the facial ligaments holding tissue in its descended position and lifts the composite structure skin, fat, and muscle together vertically. Nothing is pulled taut. The face is simply returned to where its anatomy once sat.
This distinction produces what patients describe as looking like refreshed versions of themselves rather than obviously altered. The procedure repositions the midface, jawline, and neck vertically, addressing the structural changes that cause aging rather than masking them with surface manipulation.
Clinical data support what patients report. Dr. Jacono’s 2011 Aesthetic Surgery Journal study of 153 patients recorded complication rates well below industry averages: 3.9% revisions, approximately 1.9% hematomas, and 1.3% temporary facial nerve injuries. Later research confirmed that deep-plane techniques carry a lower nerve injury risk than superficial facelifts, attributable to the preservation of anatomical relationships during dissection.
Minimal Evidence, Maximum Longevity
Incisions in Dr. Andrew Jacono’s procedure measure about one-third the length of traditional facelift incisions. Positioned behind the ear or along the hairline, they allow patients to wear hair pulled back without visible evidence of surgery a standard Dr. Jacono refers to as ponytail-friendly results.
Outcomes last 12 to 15 years, approximately double the durability of standard SMAS facelifts. Dr. Jacono performs roughly 250 procedures annually, published a medical textbook in 2021 covering more than 2,000 cases, and has trained surgeons internationally. Fashion designer Marc Jacobs and plastic surgeon Dr. Paul Nassif are among those who have publicly credited Dr. Jacono with their own facelift outcomes. See related link for additional information.
Find more information about Dr. Andrew Jacono on https://www.realself.com/dr/andrew-jacono-new-york-ny