When patients consult facial plastic surgeons, they often describe wanting to look refreshed rather than altered. That goal has historically been difficult to achieve with traditional facelift methods, which pull skin taut and leave visible evidence of the procedure. Dr. Andrew Jacono designed the Minimal Access Deep-Plane Extended facelift to meet patients precisely at that goal.

The technique operates beneath the superficial musculoaponeurotic system, treating skin, muscle, and fat as a unified structure. Town & Country reported that Dr. Andrew Jacono keeps these layers together when repositioning tissue, a biomechanical choice that eliminates the unnatural tension that older methods produce. The result looks like the patient’s own face at an earlier point, rather than a tightened approximation of it.

The Ligament Release That Changes Everything

Facial aging is driven more by tissue descent and volume depletion than by skin loosening alone. Fat pads in the midface, along the jawline, and beneath the chin migrate downward over time, changing facial proportion and contour. Conventional facelifts pull the skin in ways that address surface laxity but leave descended structures in place. Dr. Andrew Jacono’s extended deep-plane approach releases four key facial ligaments that tether tissue to bone, allowing those fat pads to be repositioned vertically to where they originated. This restoration of volume distribution accounts for the more natural appearance patients typically report.

Incisions are approximately one-third the length of those used in standard techniques, positioned behind the ear and along the hairline to remain hidden. Dr. Andrew Jacono has called the procedure ponytail-friendly because scars are concealed even with hair worn up. That practical consideration speaks to the discretion the technique affords patients who want to maintain a normal life during and after recovery.

Data Supporting Longevity

Dr. Andrew Jacono published outcomes from 153 patients in the Aesthetic Surgery Journal in 2011. Complication figures including the revision rate, hematoma rate, and rate of temporary facial nerve injury all came in below industry averages. Extended deep-plane results have been shown to last approximately twice as long as standard SMAS facelifts. Many patients maintain outcomes for more than a decade, with some surpassing 12 years. Skin quality, lifestyle, and aftercare all affect longevity, but the foundational depth of the technique provides durable support that surface approaches cannot replicate. Refer to this page, for related information.

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