How Dr. Andrew Jacono Redefined the Modern Facelift
Facial plastic surgery has long been associated with an unmistakable tightness a pulled look that announces the procedure rather than concealing it. Dr. Andrew Jacono built a career around solving that problem, developing a technique that works below the skin’s surface to produce results that hold up over time without telegraphing the surgery.
The Anatomy of a Different Approach
The Minimal Access Deep-Plane Extended (MADE) facelift, which Dr. Andrew Jacono introduced in the early 2000s, moves skin, muscle, and fat together as a unified structure. Traditional methods separate the skin from the underlying SMAS layer and pull the surface tissue upward and backward. That tension is what creates the stretched appearance many patients want to avoid. By keeping all layers connected and working beneath the SMAS, Dr. Jacono eliminates that surface tension entirely.
Four key facial ligaments anchor tissue to bone over time, and Dr. Andrew Jacono releases all of them during surgery. This allows the descended fat pads of the midface, jawline, and neck to be repositioned vertically addressing aging at its anatomical root rather than smoothing over it at the skin level.
Clinical Evidence Behind the Technique
Dr. Jacono first published his technique in Aesthetic Surgery Journal in 2011, documenting outcomes across 153 patients. The data showed a 3.9% revision rate, approximately 1.9% hematoma rate, and 1.3% temporary facial nerve injury rate figures that fall below industry averages. A 2019 publication introduced further refinements targeting jawline rejuvenation and lower-face volume, tracking improvements through quantitative measurements of jawline contour. Surgeons now use those published benchmarks as reference points for their own practices. Dr. Jacono performs roughly 250 of these procedures annually from his Manhattan practice, and his 2021 medical textbook synthesized insights from more than 2,000 facelift cases. Refer to this article for more information.
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