The face is held in place by a series of retaining ligaments that attach soft tissue to underlying bone. As these structures stretch over decades, fat pads descend, contours flatten, and the familiar signs of facial aging appear. Most facelift procedures address the results of this process. Dr. Andrew Jacono‘s extended deep-plane facelift addresses the process itself.
The Mechanics of Deep-Plane Surgery
Working below the superficial musculoaponeurotic system, Dr. Jacono releases the zygomatic and masseteric cutaneous ligaments, the structures responsible for anchoring midface tissue. Once freed, fat pads and soft tissue can be repositioned vertically, returning them to the locations they occupied in youth. Skin is redraped over this rebuilt architecture without tension. The approach differs categorically from procedures that tighten the SMAS from above and rely on skin manipulation for correction.
Dr. Andrew Jacono documented this technique’s outcomes in a 2011 study published in Aesthetic Surgery Journal, drawing on results from 153 patients. Revision rates stood at 3.9%, hematoma rates at approximately 1.9%, and temporary facial nerve involvement at 1.3%. These complication benchmarks fell below field averages, and subsequent research confirmed that deep-plane dissection carries lower nerve injury risk than superficial techniques because the anatomy is better respected during the procedure.
Long-Term Correction Through Structure
Results from the extended deep-plane technique persist 12 to 15 years, a durability advantage explained by the depth of correction. Repositioning the structural foundations of the face produces changes that outlast surface-level adjustments. Dr. Andrew Jacono performs roughly 250 of these procedures annually and has compiled findings from more than 2,000 cases into a 2021 medical textbook. He also trains surgeons through international master classes, extending the technique’s reach beyond his practice. The combination of volume, publication, and instruction reflects how a surgical innovation becomes a professional standard. Read this article for additional information.
See for more about Dr. Andrew Jacono on https://www.youtube.com/c/drandrewjacono