Every surgical field has a default approach, and questioning it takes more than curiosity alone. Dr. Andrew Jacono had to demonstrate that a fundamentally different facelift technique could outperform the standard method surgeons had relied on for decades of practice.
Two Approaches, Different Outcomes
Traditional facelifts work on the superficial musculoaponeurotic system, tightening that layer from above and trimming loose skin around the edges. The approach can produce visible improvement, but it also tends to create the stretched, artificial appearance many patients hope to avoid entirely. Dr. Andrew Jacono’s extended deep-plane method instead operates beneath that layer, keeping skin, muscle and fat connected while releasing the ligaments that anchor tissue in an aged position.
The practical differences show up clearly in the data. Jacono’s 2011 study of 153 patients recorded a 3.9 percent revision rate and complication rates that fell below typical figures reported for conventional facelifts. Results also lasted longer, twelve to fifteen years in later follow-up compared with roughly half that span for standard SMAS procedures performed elsewhere.
None of this means traditional facelifts have disappeared from practice. Many surgeons still use SMAS techniques for patients with milder aging or specific anatomical considerations that call for a lighter touch. What Dr. Andrew Jacono‘s work established is that a more involved, deep-plane approach can deliver measurably better durability and a more natural look for patients seeking a comprehensive result.
That comparison, backed by published outcomes rather than opinion alone, is part of why the extended deep-plane facelift has moved from a novel alternative to a widely taught option within facial plastic surgery over the past two decades.
Prospective patients are generally better served by asking a surgeon which layer a proposed facelift actually addresses, since that single anatomical detail correlates closely with how long the result is likely to hold. Refer to this article for more information.
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