Complication rates matter as much as aesthetic outcome when evaluating any surgical technique, and the numbers behind Dr. Andrew Jacono‘s extended deep-plane facelift have drawn attention from peers for good reason. Initial studies documented a 3.9 percent revision rate, a hematoma rate close to 1.9 percent, and a temporary facial nerve injury rate of only 1.3 percent.
Those figures matter because facial nerve injury has long been a concern with facelift surgery generally, given how closely nerves run alongside the tissue being manipulated. Dr. Jacono’s approach, which works beneath the superficial musculoaponeurotic system rather than tightening it from above, appears to lower that likelihood considerably.
Why the Deeper Layer Matters
The explanation lies in anatomy. Working underneath the SMAS layer preserves natural blood supply and keeps tissue relationships intact, rather than disrupting them the way surface-level dissection can. Later research confirmed that deep-plane techniques carry lower odds of nerve injury than superficial facelifts for exactly this reason.
Dr. Andrew Jacono’s first peer-reviewed outcomes study appeared in the Aesthetic Surgery Journal in 2011, built on data from 153 patients, and has since been followed by outcomes across more than 2,000 procedures referenced in his 2021 textbook, The Art and Science of Extended Deep Plane Facelifting.
Performing roughly 250 of these procedures each year has allowed Dr. Jacono to refine his technique continuously, the kind of repetition that tends to correlate with lower complication rates across surgical fields.
Incision placement plays into the safety picture as well. Measuring about a third the length of those in conventional facelifts and hidden behind the ear or along the hairline, the smaller incisions used in this method reduce the amount of tissue disturbed during surgery, a factor that likely contributes to the lower complication figures reported.
Combined with results that last 12 to 15 years, nearly double the span of standard SMAS facelifts, the safety profile helps explain why surgeons increasingly treat this method as the reference point for facelift surgery rather than one alternative among several. Dr. Jacono has documented these outcomes publicly through peer-reviewed research and a comprehensive 2021 textbook available to surgeons worldwide. Refer to this article to learn more.
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