Most facelift techniques start with the skin. Dr. Andrew Jacono starts deeper with the fibrous ligaments, fat pads, and muscle layers that determine how a face looks as it ages. That foundational difference is what separates the MADE facelift from the procedures that preceded it and explains the longevity of the results it produces.
What Conventional Methods Get Wrong
Traditional facelifts separate skin from the superficial musculoaponeurotic system, then pull the skin layer backward and upward. The underlying structures stay where aging left them. The result is surface tightening without structural support, which is why results from standard SMAS procedures typically last six to eight years before gravity reasserts itself. Dr. Andrew Jacono’s approach works beneath the SMAS, lifting skin, muscle, and fat together as one composite unit. The approach can last roughly twice as long as standard methods because the repositioning addresses the deeper structural causes of aging rather than its surface appearance.
Anatomy as the Guide
Faces age through two primary mechanisms: volume loss and downward tissue migration. Surface tightening addresses neither directly. The Minimal Access Deep-Plane Extended facelift developed by Dr. Andrew Jacono releases the four retaining ligaments that hold descended tissue anchored to bone, allowing vertical repositioning of midface fat pads, jowl tissue, and neck structures. Incisions are roughly one-third the length of conventional facelifts, hidden behind the ear and along the hairline. Dr. Jacono first published outcomes in Aesthetic Surgery Journal in 2011 across 153 patients, establishing complication rates below industry norms. His 2019 publication introduced quantitative tracking of jawline contour improvements, and his 2021 medical textbook drew on more than 2,000 facelift cases. He now performs approximately 250 extended deep-plane procedures per year from his Manhattan practice. Refer to this article for more information.
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