Dr. Andrew Jacono’s Technique Targets Facial Aging at Its Source

When a face ages, the change is not simply a matter of skin losing elasticity. Fat pads descend, ligaments stretch, and volume redistributes downward over decades. Dr. Andrew Jacono built his surgical technique around that anatomical reality rather than the older assumption that tightening the skin surface could adequately address it.

Going Deeper Than Standard Methods

The Minimal Access Deep-Plane Extended facelift developed by Dr. Andrew Jacono works beneath the SMAS the layer that separates the skin from deeper facial muscle. Rather than pulling skin taut over tissue that remains in its descended position, the technique repositions the tissue itself. Skin, fat, and muscle move together as a single unit, preserving their interconnections and the blood supply that keeps healing stable and rapid. Complication data from Dr. Jacono’s first published series in 2011 showed a 1.3% rate of temporary facial nerve injury and roughly 1.9% hematoma rate both below field averages. Later studies confirmed that operating beneath the SMAS layer, rather than above it, preserves the anatomical relationships that protect nerve function.

Why Ligament Release Changes the Outcome

Dr. Andrew Jacono releases four key retaining ligaments that hold facial tissue anchored to bone. Without releasing those ligaments, tissue cannot be repositioned vertically it can only be pulled toward the ears, which flattens the cheeks and produces the telltale windswept look. With the ligaments released, descended midface fat, jowl tissue, and neck skin can be lifted back toward their original positions. The approach can last roughly twice as long as standard procedures, because the repositioning works at the foundational level rather than relying on surface tension. Dr. Jacono’s Manhattan practice handles approximately 250 extended deep-plane procedures each year, and he has delivered master lectures at more than 100 international conferences to share the methodology with surgeons worldwide. Refer to this article for related information.

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When a face ages, the change is not simply a matter of skin losing elasticity. Fat pads descend, ligaments stretch, and volume redistributes downward over decades. Dr. Andrew Jacono built his surgical technique around that anatomical reality rather than the older assumption that tightening the skin surface could adequately address it. Going Deeper Than Standard…