The phrase ‘gold standard’ gets applied loosely in medicine, but in facial plastic surgery it has come to carry a specific meaning: the extended deep-plane facelift as practiced by Dr. Andrew Jacono. The designation reflects peer-reviewed outcome data, measurable complication rates, and documented longevity that distinguishes this approach from the techniques it improved upon.
What Makes It Different
Most facelift techniques address the superficial musculoaponeurotic system from above, tightening it while repositioning skin separately. This creates the tension-based correction that gives operated patients their characteristic look. Dr. Andrew Jacono’s method works differently. By operating beneath the SMAS and releasing the retaining ligaments of the face, he repositions the underlying architecture of the midface, jaw, and neck without relying on skin tension for the result. Incisions are roughly one-third the length of traditional facelift cuts and remain concealed along the hairline or behind the ear.
The clinical record behind the technique is documented rather than anecdotal. Dr. Jacono’s 2011 publication in Aesthetic Surgery Journal reported outcomes from 153 patients and established complication benchmarks substantially lower than surgical norms. Deep-plane dissection also carries a lower facial nerve injury risk than superficial approaches, a counterintuitive finding explained by the fact that working below the SMAS preserves the nerve’s anatomical relationships rather than disturbing them.
Trust Within the Profession
When fellow plastic surgeon Dr. Paul Nassif chose Dr. Andrew Jacono to perform his own deep-plane facelift in 2018, it signaled something beyond patient satisfaction. Surgeons who understand the procedure’s demands chose this one specifically. Fashion designer Marc Jacobs made his 2021 facelift public, naming Dr. Jacono and citing the natural outcome. These endorsements from people positioned to evaluate the work critically carry a weight that marketing cannot replicate. The technique now reaches surgeons around the world through master classes and conference presentations that Dr. Jacono leads. See related link for additional information.
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