A surgical advance only matters if it travels beyond its originator. Dr. Andrew Jacono developed the extended deep-plane facelift, documented its outcomes rigorously, and then built the infrastructure to transmit it: textbooks, master classes, international lectures, and a case volume that trained his own hands to a level few surgeons reach.
What the Evidence Shows
Dr. Jacono introduced the technique in the early 2000s and published his first peer-reviewed outcomes study in Aesthetic Surgery Journal in 2011, covering 153 patients. The study reported a 3.9% revision rate, approximately 1.9% hematoma rate, and 1.3% temporary facial nerve injury rate complication figures below typical facelift benchmarks. Subsequent research added a counterintuitive finding: deep-plane dissection carries a lower facial nerve injury risk than superficial facelifts, because working beneath the superficial musculoaponeurotic system preserves the anatomical relationships that protect nerve pathways.
The technique itself differs from conventional approaches at a conceptual level. Standard facelifts separate skin from deeper tissue and reposition the surface layer, generating visible tension. Dr. Andrew Jacono works beneath the SMAS, releases the facial ligaments holding descended tissue, and lifts skin, fat, and muscle together as one unit. The midface, jawline, and neck return to vertical positions they held in younger anatomy, producing natural contour rather than surface tightness.
Building a Lasting Practice
Results from the extended deep-plane facelift last 12 to 15 years roughly twice as long as standard SMAS procedures. Incisions measure about one-third the length of traditional facelift scars and are hidden along the hairline or behind the ear, allowing patients to wear their hair pulled back without visible surgical evidence.
Dr. Andrew Jacono performs approximately 250 of these procedures per year. In 2021, he published a comprehensive textbook synthesizing lessons from more than 2,000 cases and branded the approach The Jacono Method. He has trained surgeons internationally through master classes and conference appearances. Both fashion designer Marc Jacobs and plastic surgeon Dr. Paul Nassif have publicly credited Dr. Jacono with their own facelift outcomes, reflecting confidence from patients and surgical peers alike. Read this article for related information.
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