Surgical innovation rarely happens in a single moment. Dr. Andrew Jacono spent years developing, refining, and formally documenting his approach to facial rejuvenation a process that resulted in the Minimal Access Deep-Plane Extended facelift, a technique that has since become a reference point for surgeons across the field.

From Development to Documentation

Dr. Jacono introduced the MADE facelift in the early 2000s. The procedure moves skin, muscle, and fat as a unified composite rather than separating the skin from the tissue beneath, which is what most conventional methods do before pulling the surface layer taut. He published the first formal outcomes data in Aesthetic Surgery Journal in 2011, covering 153 patients. The documented complication rates 3.9% revision, 1.9% hematoma, 1.3% temporary facial nerve injury were below industry norms and gave other surgeons a clinical benchmark to evaluate the approach.

Refining the Technique Over Time

A 2019 publication by Dr. Andrew Jacono introduced additional refinements specifically targeting jawline rejuvenation and volume enhancement in the lower face. That paper used quantitative measurements including a metric tracking jawline contour called the “mandibular defining line” to document outcomes in a way that allowed objective comparison across patients. The technique releases four major facial retaining ligaments that hold tissue in its descended position, allowing vertical repositioning of midface fat pads, jowl tissue, and neck structures. Incisions measure roughly one-third the length of standard facelifts, hidden behind the ear and along the hairline. By 2021, Dr. Jacono had synthesized more than 2,000 facelift cases into a medical textbook that other surgeons now use as a technical reference. He performs roughly 250 extended deep-plane facelifts annually and has lectured at more than 100 international conferences. See related link for more information.

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