Facial plastic surgery changed shape gradually, one refinement at a time, but Dr. Andrew Jacono’s contribution stands out as a genuine departure from the surface-tightening model that dominated for most of the twentieth century. Rather than accepting the SMAS-lift as the ceiling for what facelift surgery could achieve, he spent years developing an operation that reaches beneath that layer entirely.

Working Below the Surface

The Minimal Access Deep-Plane Extended facelift, the formal name for Dr. Andrew Jacono‘s technique, releases four ligaments that hold facial tissue against the underlying bone. Once those ligaments are freed, fat pads that have descended in the midface, jawline, and neck can be repositioned along a vertical vector instead of the diagonal pull used in older methods. This is a mechanical distinction with real consequences: pulling skin backward tends to widen and flatten a face, while lifting tissue upward restores contour without erasing individual features.

Jacono introduced the approach in the early 2000s and formalized it in a 2011 paper in the Aesthetic Surgery Journal that reviewed outcomes across 153 patients. That early dataset gave other surgeons a benchmark for comparison and helped the technique move from a single practitioner’s innovation toward broader adoption. He returned to the work in 2019 with modifications aimed specifically at jawline definition and lower face volume, introducing measurements such as the mandibular defining line to quantify improvements that had previously been judged only by eye.

A Practice Built on Repetition

Today Dr. Andrew Jacono performs roughly 250 extended deep-plane facelifts each year at his Manhattan practice, a volume that has sharpened his judgment about which ligaments to release and which vectors produce the most natural lift. That repetition matters in a procedure where small variations in technique can change how long results last and how a face moves after healing. His 2021 textbook drew on insights from more than 2,000 facelift procedures, turning individual experience into a reference other surgeons now consult. See related link for additional information.

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