The wind-tunnel look that once defined cosmetic facelifts was not a design flaw so much as a predictable consequence of the technique. When a surgeon pulls only the skin layer tighter, the result carries the tension of that manipulation. The face does not age through skin stretching, so correcting it that way creates a mismatch between what was done and what the anatomy needed. Recognizing that disconnect led Dr. Andrew Jacono to develop a fundamentally different approach.

The extended deep-plane facelift works beneath the SMAS layer, the connective tissue that links facial muscles to the skin above. Dr. Andrew Jacono releases the ligaments that hold descended tissue in place, then repositions the midface, jawline, and neck structures in a vertical direction. Because skin, muscle, and fat move together rather than separately, the correction reflects how the face actually aged and restores a version of its earlier anatomy. Patients report looking like younger versions of themselves, not different people.

Incision Design Minimizes Visible Evidence

The technique also addresses scarring more effectively than conventional methods. Incisions measure approximately one-third the length of standard facelift incisions and are placed behind the ear or along the hairline. The result is what Dr. Jacono calls ponytail-friendly outcomes, where patients can wear their hair up without revealing any evidence of a procedure. This design reflects the technique’s broader philosophy: the goal is a result that neither looks nor feels surgical.

Documented Longevity and Safety

Dr. Jacono published his first peer-reviewed study in Aesthetic Surgery Journal in 2011 based on 153 patients. Complication rates fell below industry norms: 3.9% revision rate, approximately 1.9% hematoma rate, and 1.3% temporary facial nerve injury. Results from the extended deep-plane facelift last 12 to 15 years, roughly double the lifespan of standard SMAS facelifts. Dr. Andrew Jacono has since performed well over 2,000 of these procedures, documenting outcomes in a comprehensive medical textbook and training surgeons worldwide through lectures and master classes at international plastic surgery conferences. Refer to this article for related information.

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