The goal of facial rejuvenation surgery has always been to make patients look younger, not different. Achieving that outcome consistently requires understanding what changes as the face ages a question that shaped Dr. Andrew Jacono’s development of the Minimal Access Deep-Plane Extended facelift.
Facial aging is driven primarily by two forces: volume loss and the downward migration of soft tissue. Skin laxity is a result of these changes, not their origin. Traditional facelifts have historically treated the symptom removing or tightening excess skin without correcting the structural shifts below. Dr. Andrew Jacono’s technique goes to the source, operating beneath the SMAS layer to reposition the fat pads and tissue that have descended over time.
Vertical Lift Over Surface Pull
One of the defining characteristics of Dr. Andrew Jacono‘s approach is the direction of the lift. Traditional procedures typically pull tissue backward and upward toward the ears, which flattens the cheeks and can alter the appearance of the corners of the eyes and mouth. The extended deep-plane method repositions tissue vertically, working against the downward direction of gravitational aging. This recreates the contour of a younger face rather than simply tightening the one that time has altered. Town and Country noted that the method involves keeping skin, muscle, and fat as one unit during repositioning, which is the anatomical reason the lift appears natural.
Data Behind the Technique
Dr. Andrew Jacono began developing the MADE facelift in the early 2000s and published his first clinical documentation in Aesthetic Surgery Journal in 2011, covering 153 patients. Complication rates fell below industry averages for all measured categories. A 2019 paper introduced further refinements for jawline definition and lower-face volume, tracked with quantitative measurements. The approach produces results that last approximately twice as long as standard SMAS facelifts, with incisions one-third the conventional length, hidden along the hairline and behind the ear. Dr. Andrew Jacono performs roughly 250 of these procedures annually and has taught the technique at over 100 international conferences. Refer to this article for related information.
More about Dr. Andrew Jacono on https://www.facebook.com/DrJacono/