Facelift patients once had to pick between two outcomes. They could look younger, or they could look natural, and few managed both. The stretched, wind-tunnel appearance that followed many procedures became shorthand for obvious cosmetic surgery. A New York facial plastic surgeon, Dr. Andrew Jacono, set out to change that by walking away from the skin-tightening method that had defined the operation since its beginnings.
Rebuilding Instead of Pulling
The extended deep-plane facelift, which Dr. Andrew Jacono introduced in the early 2000s, takes a different route. Conventional facelifts separated the skin from the tissue beneath it and then repositioned only that outer layer. Tension on the skin did most of the work, which explains the pulled look so many people came to dread.
Dr. Jacono keeps skin, muscle, and fat attached to one another as a single unit. He then lifts the deeper structures of the midface, jawline, and neck in a vertical direction. The goal is to restore the face’s underlying architecture, the framework that sags as fat pads descend and ligaments stretch over the years.
People who undergo the procedure tend to describe themselves as refreshed versions of who they were, not as altered. That reaction follows from the method’s focus on anatomical position. When tissue returns to where it once sat, the skin does not need to be pulled taut to look smooth.
A Shift in Surgical Thinking
Supporters describe the technique as a philosophical change in facial rejuvenation. Earlier approaches treated aging as a skin problem and tried to fight gravity at the surface. Dr. Andrew Jacono treated it as a structural problem, reasoning that correcting deep tissue would produce broader and more durable improvement than any amount of surface tightening.
Published outcomes back up that reasoning. Results from his technique last 12 to 15 years, roughly double the lifespan of a standard SMAS facelift. Complication rates reported in his studies also fall below industry averages for facelift procedures.
What began as a challenge to the basic mechanics of an older operation has since reached a wider audience. He has taught the method to other surgeons through master classes and lectures at international plastic surgery conferences. this page for more information.
See for more about Dr. Andrew Jacono on https://www.instagram.com/drjacono/?hl=en