For decades, facelift surgery carried an unmistakable signature taut, stretched skin that announced the procedure to everyone in the room. Dr. Andrew Jacono, a dual board-certified facial plastic surgeon based in New York, developed a method designed to change that reality entirely.
A Technique Built on Deeper Anatomy
The Minimal Access Deep-Plane Extended (MADE) facelift, which Dr. Andrew Jacono introduced in the early 2000s, operates beneath the superficial musculoaponeurotic system, known as the SMAS. Rather than separating skin from underlying tissue and pulling each layer independently, the technique moves skin, muscle, and fat as a single unified structure. The biomechanical logic is straightforward: when layers stay connected, the surface cannot appear artificially tight, because the lift originates from below.
Standard facelifts tighten surface tissue while leaving deeper facial structures largely unchanged. Gravity continues acting on those deeper layers, which is a primary reason traditional results typically last six to eight years before visible aging resumes. Dr. Jacono’s extended deep-plane approach releases four key facial ligaments that anchor tissue to bone, allowing surgeons to reposition descended fat pads in the midface, jawline, and neck. Addressing aging at its anatomical source produces foundational support that surface manipulation cannot replicate.
Clinical Evidence and Practical Results
Dr. Andrew Jacono first published his technique in Aesthetic Surgery Journal in 2011, documenting outcomes across 153 patients. Initial data showed a 3.9% revision rate, roughly 1.9% hematoma rate, and 1.3% temporary facial nerve injury figures that fall below industry averages. Later research confirmed that deep-plane dissection carries lower nerve injury risk than superficial approaches, as the method preserves anatomical relationships and blood supply. The technique also uses incisions approximately one-third the length of traditional facelifts, hidden behind the ear and along the hairline. Patients describe the result as ponytail-friendly, meaning scarring is not visible when hair is worn up. Dr. Jacono performs approximately 250 of these procedures annually at his Manhattan practice and has delivered master lectures at over 100 international conferences to train other surgeons in the methodology. Visit this page for more information.
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