Surgical innovation rarely announces itself. More often, it emerges from careful observation, repeated procedure, and a willingness to question established methods. Dr. Andrew Jacono’s development of the Minimal Access Deep-Plane Extended facelift follows that pattern a technique refined over two decades of clinical practice that has reshaped what many consider the gold standard in facial rejuvenation.

The problem with traditional facelifts, as Dr. Andrew Jacono describes it, is architectural. Standard procedures separate skin from the superficial musculoaponeurotic system, tighten each layer independently, and rely on the skin surface to hold the aesthetic result. This approach creates tension at the wrong location. The skin, pulled backward and upward, telegraphs the surgery. Results also tend to fade within six to eight years as deeper facial structures untouched by the procedure continue descending.

Rebuilding From Below

Dr. Andrew Jacono’s extended deep-plane technique operates beneath the SMAS, where skin and muscle remain attached and travel together during repositioning. By releasing four key retaining ligaments that anchor tissue to bone, the surgeon can move fat pads in the cheeks, jowls, and neck upward and inward vertically, against the direction of gravity. The result addresses facial aging at its anatomical foundation rather than at the surface. Research has shown that this repositioning restores midface volume equivalent to approximately three vials of injectable filler, achieved without any augmentation material.

Teaching a New Generation of Surgeons

Dr. Andrew Jacono introduced the technique in the early 2000s, published his first formal documentation in Aesthetic Surgery Journal in 2011, and followed with a 2019 refinement targeting jawline rejuvenation. He performs approximately 250 extended deep-plane facelifts annually, teaches the method at over 100 international conferences, and authored a 2021 medical textbook drawing on insights from more than 2,000 procedures. Even fellow plastic surgeons have sought out his expertise: Dr. Paul Nassif traveled from Beverly Hills to New York specifically for Dr. Jacono’s procedure. Incision lengths measure roughly one-third of traditional techniques, hidden behind the ear and along the hairline. Refer to this article to learn more.

Follow their page on https://www.instagram.com/drjacono/?hl=en