Every facelift technique makes a bet about where aging actually happens. Older methods bet on the skin, treating sagging as a surface problem solved by pulling tissue tighter. Dr. Andrew Jacono bet on the structures underneath, and the difference has reshaped how many surgeons think about facial rejuvenation over the past two decades.
Beneath the SMAS
Dr. Andrew Jacono developed his extended deep-plane technique by working below the superficial musculoaponeurotic system, the tissue layer that connects facial muscle to skin. He releases the ligaments anchoring that layer in place, then repositions the midface, jawline, and neck together, vertically, as fat pads and muscle shift back toward their original positions rather than simply being smoothed over.
This matters because sagging is a structural issue as much as a skin issue. Over decades, fat pads descend and ligaments stretch, and no amount of surface tightening addresses those deeper changes. Dr. Jacono’s method corrects the underlying architecture directly instead of masking its effects, which is why the results tend to hold up over time.
Testing the Theory
He published his first major study in the Aesthetic Surgery Journal in 2011, tracking 153 patients and reporting a revision rate under four percent. Complication figures, including a hematoma rate near two percent and temporary nerve injury near one percent, held up well against industry norms for facelift surgery published around the same period.
The technique’s incisions also measure about a third the length of conventional cuts, hidden behind the ear or along the hairline. Combined with results that last twelve to fifteen years, the approach gives patients a case for surgery built on published data rather than assumption or marketing language alone, a distinction that matters more as patients grow more skeptical of cosmetic surgery claims in general.
That skepticism is healthy, and it is part of why Jacono continues to publish outcomes rather than relying solely on before-and-after photographs to make his case to prospective patients. Refer to this article for related information.
Learn more about Dr. Andrew Jacono on https://www.bbntimes.com/science/what-peer-recognition-and-national-rankings-reveal-about-dr-andrew-jacono-s-surgical-reputation