Most surgical innovations arrive quietly, tested in small studies before gradually gaining acceptance. The extended deep-plane facelift followed a different path, earning recognition across the medical community relatively quickly because its outcomes were both measurable and visible. Lower complication rates, longer-lasting results, and a natural appearance that distinguished it from the pulled look of conventional facelifts made a compelling case that did not require extensive persuasion.
The surgeon behind that case is Dr. Andrew Jacono, who introduced the technique in the early 2000s and published the first peer-reviewed study on its outcomes in Aesthetic Surgery Journal in 2011. That initial study tracked 153 patients and produced complication data that sat well below industry averages: 3.9% revision rate, roughly 1.9% hematoma rate, and 1.3% temporary facial nerve injury. The technique’s core departure from conventional methods is anatomical. Where standard facelifts pull only the skin layer tighter, Dr. Jacono works beneath the SMAS to release descended tissue and reposition the full structural composite of the face.
The Structural Logic of the Technique
Aging manifests structurally before it shows on the surface. Fat pads migrate downward, ligaments lose tension, and bone resorption shifts the frame that underlies facial appearance. A technique that treats only the skin misses the underlying cause. Dr. Andrew Jacono’s extended deep-plane approach releases the ligaments anchoring tissue in a descended position, then moves the entire composite structure together. Because the correction matches the mechanism of the problem, the result looks anatomically correct rather than artificially smoothed.
Longevity and Recognition
Published outcomes from Dr. Jacono’s practice show results lasting 12 to 15 years, approximately twice the duration of standard SMAS facelift results. The incisions measure one-third the length of conventional approaches and are hidden behind the ear or along the hairline. Dr. Andrew Jacono performs roughly 250 of these procedures annually and has trained surgeons internationally through lectures and master classes. His 2021 textbook on the method codifies the technical approach for the broader surgical community, extending the technique’s reach across practices well beyond his own. See related link for additional information.
Watch for more about Dr. Andrew Jacono about Colcom on https://www.youtube.com/c/drandrewjacono