Dr. Andrew Jacono Changed Facelift Surgery with One Key Innovation

Surgical progress is often framed as the accumulation of small improvements. Sometimes, though, a single conceptual shift produces an outsized change in outcomes. For facelift surgery, Dr. Andrew Jacono‘s decision to operate beneath the superficial musculoaponeurotic system and treat skin, muscle, and fat as one unit rather than separating them represented precisely that kind of shift.

Traditional facelift techniques lift the skin away from the SMAS, pull the skin upward, and secure it under tension. The result tightens the surface but leaves the deeper structural causes of aging untouched. Volume loss and tissue descent continue beneath the surface. Dr. Andrew Jacono’s Minimal Access Deep-Plane Extended facelift addresses those deeper changes by releasing the facial ligaments that anchor descended tissue to bone, then repositioning it vertically to restore the contours and proportions of youth.

The Science Behind Ligament Release

The face is held in shape partly by retaining ligaments that connect skin and soft tissue to the underlying bone. With age, these ligaments stretch and tissue descends, creating the jowling, flattened midface, and neck laxity that patients seek to correct. Standard facelifts do not address those ligaments. The extended deep-plane approach targets them directly, releasing four key anchors that allow fat pads in the midface, jawline, and neck to be repositioned upward. The resulting lift is vertical rather than lateral, which more closely mirrors how the face looked before age-related descent occurred.

Dr. Andrew Jacono first documented outcomes in 153 patients in a 2011 Aesthetic Surgery Journal paper. Complication rates across revision, hematoma, and temporary facial nerve injury fell below industry averages. Later publications introduced jawline refinements and quantified improvement using measurable anatomical landmarks. His 2021 textbook, drawing on more than 2,000 procedures, provided surgical peers with a reproducible technical standard. He has since lectured at over 100 international conferences, and the New York facial plastic surgeon performs approximately 250 of these procedures annually.

What Patients Experience

Incisions in the MADE technique run roughly one-third the length of conventional facelift incisions and are hidden behind the ear and along the hairline. Dr. Andrew Jacono describes the result as ponytail-friendly, a practical way of conveying that scars remain invisible in everyday situations. Results last approximately twice as long as standard SMAS facelifts, with many patients reporting sustained outcomes past a decade. Marc Jacobs described his own experience in Vogue in 2021, saying the results looked natural, not surgical. See related link for additional information.

Learn more about Dr. Andrew Jacono on https://www.realself.com/dr/andrew-jacono-new-york-ny