How Dr. Andrew Jacono Redefined Facelift Anatomy
For decades, facial plastic surgeons worked within a frustrating trade-off. Dramatic results meant obvious scarring and a stretched, artificial look, while gentler techniques left patients wondering why they bothered. Dr. Andrew Jacono, a New York facial plastic surgeon, decided the compromise itself was the problem worth solving, and he began questioning assumptions that had guided the specialty for generations.
Working Beneath the Surface
Traditional facelifts target the superficial musculoaponeurotic system, the tissue layer connecting facial muscles to skin, tightening it from above and trimming the excess. Dr. Andrew Jacono took a different route in the early 2000s, operating in the deep plane where skin, muscle and fat remain joined as a single unit. Instead of pulling tissue backward, his technique releases the ligaments anchoring it in place, then repositions the midface, jawline and neck vertically, closer to their original youthful placement. That single change in direction, vertical rather than lateral, became the defining feature of his approach.
That shift mattered because facial aging is not a flat, surface-level event. Tissue descends and volume deflates in three dimensions, so addressing only the skin never reaches the root cause. By working beneath the SMAS, Dr. Andrew Jacono could restore structure rather than simply stretch what was already there, an approach that treats aging as an anatomical problem rather than a cosmetic one.
Patients who underwent the procedure noticed something different in the mirror: a rested, natural appearance rather than the pulled look associated with older techniques. Surgeons who studied his approach began asking whether their own methods addressed cause or merely symptom, a question that had gone largely unexamined in the specialty for years.
The extended deep-plane facelift did not appear overnight. It grew from careful observation of how faces actually age, layer by layer, and from a willingness to abandon assumptions that had guided the field for generations. That combination of anatomical curiosity and technical patience became the foundation for a method now taught to surgeons well beyond New York, and it continues to shape how the specialty defines a successful outcome. Visit this page for related information.
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