For much of cosmetic surgery’s history, facelift outcomes reflected the limits of the technique rather than the patient’s underlying anatomy. Skin-tightening procedures created unnatural tension that aged poorly and announced themselves visually for years afterward. Surgeons trained in these methods accepted the trade-off as inherent to working on the face. One New York plastic surgeon challenged that assumption directly and spent two decades building a body of peer-reviewed evidence to back his alternative approach.

Dr. Andrew Jacono developed the extended deep-plane facelift by moving the surgical plane beneath the SMAS layer. Where conventional facelifts tightened the superficial musculoaponeurotic system from above, his technique releases it from below, freeing the facial ligaments that tether descending fat compartments to bone. The repositioned composite of skin, muscle, and fat returns to the elevated anatomical position it occupied years earlier. No amount of surface manipulation can replicate that structural correction, which explains why conventional facelifts consistently produce different and less durable outcomes.

Evidence and Broad Adoption

In 2011, Dr. Andrew Jacono published the first peer-reviewed study of his technique in Aesthetic Surgery Journal, documenting 153 cases. Revision rates, hematoma incidence, and facial nerve injury all fell below industry benchmarks. That study established a clinical foundation for what he calls The Jacono Method. Results hold for 12 to 15 years, compared to roughly half that duration for standard SMAS procedures.

The technique’s adoption now extends beyond Dr. Jacono’s own New York practice. Fashion designer Marc Jacobs publicly credited Dr. Jacono following his 2021 facelift, praising the natural outcome. More significant within the surgical community was the 2018 decision by Dr. Paul Nassif, a fellow plastic surgeon, to choose Dr. Jacono for his own deep-plane facelift. Surgeons choosing colleagues for personal procedures reflects clinical judgment rather than consumer preference. Dr. Jacono’s lectures at international plastic surgery conferences and his 2021 medical textbook, drawing on over 2,000 cases, have positioned the extended deep-plane facelift as a contemporary standard in facial rejuvenation. Visit this page for related information.

Find more information about Dr. Andrew Jacono on https://ceoworld.biz/2026/02/28/facelift-longevity-why-dr-andrew-jaconos-approach-lasts-over-a-decade/