A 2011 paper in the Aesthetic Surgery Journal changed how facial plastic surgeons think about the facelift. Documenting results from 153 patients, it introduced a technique built around repositioning the face’s structural layers rather than pulling its surface. The surgeon behind it, Dr. Andrew Jacono, a dual board-certified facial plastic and reconstructive surgeon based in Manhattan, had spent years refining an approach that produced results that look natural and hold their position far longer than conventional methods. More than a decade later, that research has been followed by more than 70 peer-reviewed publications and an international lecture record spanning four continents. The technique he formalized is now one of the most studied facelift approaches in facial plastic surgery. The results patients report are not just durable. They look, as Dr. Jacono puts it, like a “reset” rather than an overhaul.
What Separates the Deep Plane from Conventional Facelifting
The distinction starts beneath the skin. Traditional facelift techniques separate the dermis from the muscle beneath it, then pull the skin in an upward or backward direction to reduce visible sagging. That separation creates tension, and tension is what produces the telltale tightness that signals a surgical result to anyone in the room.
Dr. Andrew Jacono’s approach lifts the skin, muscle, and fat together as one cohesive unit. Operating beneath the superficial musculoaponeurotic system (SMAS), he releases the retaining ligaments that anchor facial tissue downward and repositions the midface, jawline, and neck pads vertically rather than laterally. The tissue goes back to where it once was, not to a position that merely approximates youth under surface pressure.
Vogue Turkey, covering the procedure’s anatomy in April 2026, described the outcome this way: the deep plane “goes deeper than the traditional procedure,” and Dr. Jacono explained the rationale directly: “This procedure focuses on freeing and repositioning deep muscle and fat layers, rather than stretching the skin.” The result is higher cheekbones, softened nasolabial grooves, and a cleaner jawline achieved through structural repositioning rather than surface manipulation.
The Daily Mail noted an additional element that surgeons who have studied Dr. Jacono’s technique consistently highlight: because the skin and SMAS layer are moved together in a block and the face-descending ligaments are released, there is no unnatural tension on the skin itself. “The skin isn’t pulled separately,” the publication reported, “so there’s no unnatural tension and a softer effect is achieved.”
Longevity, Incision Design, and What the Data Shows
The durability of results sets the extended deep-plane apart from procedures that address surface tissue only. Dr. Andrew Jacono reports that results from his technique last 12 to 15 years, roughly twice the lifespan of a standard SMAS facelift, because the deeper tissue support maintains its position longer than surface tension alone can. Key factors that affect the longevity of the extended deep-plane facelift include technique, lifestyle, skin quality, and care.
Incision design is another area where the technique diverges from older approaches. Dr. Jacono uses incisions measuring approximately one-third the length of traditional facelift incisions, tucked behind the ear and along the hairline, where they are largely invisible. The design, which he describes as “ponytail-friendly,” allows patients to wear their hair up without revealing evidence of surgery.
He performs approximately 250 deep-plane facelifts annually at his Park Avenue practice. That volume has informed a continuous refinement process: a 2019 publication in Aesthetic Surgery Journal introduced further modifications for jawline rejuvenation and lower-face volumization, and his 2021 medical textbook, The Art and Science of Extended Deep Plane Face Lifting, documents the technique’s anatomical basis and clinical outcomes in full.
A Record Built on Peer Review and Fellowship Training
The volume of published research supporting Dr. Jacono’s work is not incidental to his clinical reputation. He has authored more than 70 peer-reviewed articles in journals including Aesthetic Surgery Journal and JAMA Facial Plastic Surgery, and has presented clinical research and conducted live surgery at more than 100 plastic surgery meetings and symposiums globally, including those hosted by the International Master Course on Aging Skin (IMCAS), the European Academy of Facial Plastic Surgery (EAFPS), and the International Society of Aesthetic Plastic Surgery (ISAPS).
Dr. Andrew Jacono has served for most of his career as a Fellowship Director for the American Academy of Facial Plastic and Reconstructive Surgery. He has trained Fellows from the American Academy of Facial Plastic and Reconstructive Surgery in advanced techniques, ensuring that the anatomical principles underlying the extended deep-plane approach pass forward to the next generation of specialists rather than remaining concentrated in a single practice.
That commitment to documented outcomes and peer accountability shapes how patients and surgeons alike evaluate his work. When a procedure produces a 3.9% revision rate across 153 patients, or when a technique earns keynote lecture invitations from surgical societies across four continents, the claims to longevity and natural results carry the weight of institutional verification, not marketing copy.
Patients, Dr. Jacono says, return to their social lives after four to six weeks, with friends commenting that they look well, not that they look different. That outcome, subtle enough to be undetectable and durable enough to last more than a decade, is the benchmark the technique is built around.
