Long scars have been one of the main drawbacks of facial rejuvenation surgery. Dr. Andrew Jacono‘s Minimal Access Deep-Plane Extended facelift tackles that problem with incisions about one-third the length of those in a traditional procedure. They are placed behind the ear and along the hairline, where they are easy to hide.
Jacono describes the result as “ponytail-friendly.” Patients can sweep their hair up without exposing the marks of surgery, a practical benefit for anyone who prefers to keep their procedure private.
Doing More Through Less
A shorter incision might suggest a lighter operation. The reverse is true here. Working through that limited access, the surgeon goes beneath the superficial musculoaponeurotic system, the SMAS, to release four ligaments that fix facial tissue to bone. Descended fat in the midface, jawline, and neck can then be lifted vertically.
Skin, muscle, and fat move as one piece. Older facelifts separate the skin and pull it tight across the tissue below, and that tension tends to show. Keeping the layers attached avoids the stretched look.
Results That Hold
Standard facelifts commonly last six to eight years. The extended deep-plane approach can endure roughly twice that, and many patients keep their results more than a decade, with some going beyond 12 years. Technique, skin quality, lifestyle, and care each shape the outcome. Faces age through volume loss and downward drift, so supporting deeper tissue holds up longer than tightening skin.
Dr. Andrew Jacono first published the method in Aesthetic Surgery Journal in 2011 after treating 153 patients. The data showed a 3.9% revision rate, a hematoma rate of roughly 1.9%, and temporary facial nerve injury in 1.3% of cases, all below industry averages.
Experience has deepened since Dr.Andrew Jacono dual board-certified surgeon now performs around 250 extended deep-plane facelifts per year in Manhattan, and his 2021 textbook drew on more than 2,000 facelift procedures. That record helps explain why Dr. Andrew Jacono’s minimal access approach is now taught to surgeons around the world. Refer to this article for related information.
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