A facelift that lasts five to seven years requires another procedure to maintain results. One that lasts 12 to 15 years changes the calculation entirely, reducing both the cumulative surgical exposure and the long-term cost for the patient. That durability gap between the extended deep-plane facelift and standard SMAS techniques is one of the most clinically significant differences Dr. Andrew Jacono cites when comparing the approaches, and it flows directly from how the two methods treat the face at different anatomical depths.
Standard facelifts achieve their results by pulling the skin tighter after separating it from the underlying tissue. The SMAS layer, which connects facial muscles to the overlying skin, is addressed from above or left largely untouched. The results rest on surface tension, which the body gradually overrides over time. Dr. Andrew Jacono works beneath the SMAS, releasing the ligaments that hold descended tissue in place and repositioning the midface, jawline, and neck structures in the vertical direction they moved away from during the aging process.
Why Depth Produces Duration
By treating structural change at its source, the extended deep-plane facelift creates support from within rather than tension from outside. Fat pads return to their earlier positions, ligaments are reestablished at appropriate tension, and the composite unit of skin, muscle, and fat holds that position because the underlying anatomy supports it. This is why Dr. Jacono’s published outcomes show results persisting for 12 to 15 years rather than the five to seven typical of surface-level approaches.
Documented Safety and Refinement
Dr. Andrew Jacono published initial outcomes in Aesthetic Surgery Journal in 2011 from 153 patients. The 3.9% revision rate, roughly 1.9% hematoma rate, and 1.3% temporary facial nerve injury rate compared favorably with industry benchmarks. Later research confirmed that deep-plane dissection reduces facial nerve injury risk compared to superficial techniques by preserving anatomical relationships during the procedure. Dr. Jacono performs roughly 250 of these facelifts each year, which generates a continuous stream of outcome data feeding into his teaching through international conferences, master classes, and his 2021 textbook on extended deep-plane facelifting. See related link for more information.
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