Dr. Andrew Jacono’s Approach to the Jawline and Neck
Along the jawline and neck, facial aging can be hard to miss. Fat that once sat higher in the face drifts downward, and the edge of the lower face softens. Dr. Andrew Jacono’s extended deep-plane facelift was built to address that descent at its anatomical source.
The procedure, formally the Minimal Access Deep-Plane Extended (MADE) facelift, operates beneath the superficial musculoaponeurotic system (SMAS). Skin, muscle, and fat stay connected throughout. Four ligaments that anchor tissue to bone are released, allowing descended fat pads in the midface, jawline, and neck to be repositioned vertically.
A 2019 Focus on the Lower Face
Dr. Andrew Jacono published a refinement in 2019 that added modifications for jawline rejuvenation and volume enhancement in the lower face. He documented the work in medical literature with quantitative evidence. One measurement, the “mandibular defining line,” tracks how jawline contour improves. The measurement gives a way to compare contours before and after surgery rather than relying on impressions alone.
That emphasis on measurable outcomes runs through his career. His original 2011 paper in Aesthetic Surgery Journal covered 153 patients and reported a 3.9% revision rate, about 1.9% hematoma, and 1.3% temporary facial nerve injury. Those rates fall below industry averages for facelifts.
Why Lifting Deeper Matters
Standard facelifts tighten the skin over the SMAS without moving the deeper tissue that has slipped. They typically last six to eight years. The deep-plane approach provides foundational support instead, and it can last roughly twice as long. Many patients keep their results for more than a decade. Lifestyle, skin quality, and care also affect how long results hold.
Incisions are about one-third the length of a traditional facelift’s and are hidden behind the ear and along the hairline. Dr. Andrew Jacono performs approximately 250 of these facelifts a year at his Manhattan practice, and his 2021 textbook drew on more than 2,000 procedures. Town & Country described his method this way: “Jacono keeps the skin, muscle, and fat as one unit.” Read this article for related information.
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