The Science Behind Dr. Andrew Jacono’s Extended Deep-Plane Facelift
Most surgical advances refine existing methods. Fewer require abandoning the logic that made those methods standard. Dr. Andrew Jacono’s extended deep-plane facelift belongs to the rarer category a technique that works not by improving what conventional facelifts do but by doing something categorically different.
Anatomy as the Starting Point
Conventional facelift techniques separate skin from the deeper tissue layers, then reposition only the skin. The problem with this approach is that skin tension is visible: it produces the stretched, artificial look that has long made facelift surgery recognizable to observers. Dr. Andrew Jacono‘s method begins beneath the superficial musculoaponeurotic system, the connective layer that ties facial muscles to overlying skin. Rather than working above this layer and tightening it from the outside, he releases the facial ligaments holding descended tissue and lifts the deeper structures muscle, fat, and skin as one composite unit.
This anatomical approach does something conventional methods cannot: it moves tissue to where it used to sit rather than pulling skin over tissue that hasn’t moved. The midface, jawline, and neck structures are repositioned vertically, restoring the spatial arrangement of youthful facial anatomy.
Dr. Andrew Jacono published outcome data from 153 patients in Aesthetic Surgery Journal in 2011. The procedure showed a 3.9% revision rate, roughly 1.9% hematoma rate, and 1.3% temporary facial nerve injury rate. These figures fell below typical facelift benchmarks. Research also found that deep-plane dissection reduces nerve injury risk compared to superficial approaches because it keeps intact the anatomical context that protects nerves.
Longevity and Minimal Scarring
Published outcomes show results lasting 12 to 15 years about twice the durability of standard SMAS facelifts. Incisions measure approximately one-third the length of those used in traditional procedures and are hidden along the hairline or behind the ear.
Dr. Andrew Jacono performs close to 250 of these procedures each year. He published a 2021 textbook based on more than 2,000 cases and has conducted international master classes training other surgeons in the technique. Both Marc Jacobs and Dr. Paul Nassif have publicly associated their own facelift procedures with Dr. Jacono’s work. Visit this page for more information.
Visit to learn more about Dr. Andrew Jacono on https://www.youtube.com/c/drandrewjacono