A defined jawline is one of the first features to soften with age. Fat pads descend, the contour blurs, and the border between face and neck loses its crispness. Dr. Andrew Jacono addressed that area directly in a 2019 refinement of his extended deep-plane facelift.

The update added modifications for jawline rejuvenation and for volume enhancement in the lower face. Jacono documented the changes in medical literature and supported them with quantitative evidence, including measurements of the “mandibular defining line,” which tracks improvements in jawline contour.

The Foundation Beneath the Refinement

The 2019 work builds on a technique Jacono introduced in the early 2000s and first published in Aesthetic Surgery Journal in 2011. Called the Minimal Access Deep-Plane Extended facelift, it operates beneath the superficial musculoaponeurotic system instead of above it.

Conventional facelifts lift skin off the SMAS and pull it backward. Dr. Andrew Jacono’s method releases four ligaments that anchor facial tissue to bone, so fallen fat in the midface, jawline, and neck can be raised vertically. Skin, muscle, and fat stay together as one unit, which helps avoid the taut, pulled appearance of older surgery.

Why the Jawline Responds Well

Jawline sagging stems from tissue migrating downward and volume disappearing, more than from loose skin alone. Repositioning deeper structures restores the support that the lower face has lost.

The original 153-patient series showed favorable safety numbers: a 3.9% revision rate, about 1.9% hematoma, and 1.3% temporary facial nerve injury. Each was below industry averages. Durability is another strength. Standard SMAS facelifts typically last six to eight years, while the extended deep-plane approach can last about twice as long, frequently beyond a decade.

Incisions remain small, roughly one-third the length of traditional ones, and stay hidden behind the ear and along the hairline.

Dr. Andrew Jacono performs about 250 of these procedures annually in New York and has taught the method at more than 100 international conferences. The jawline refinement shows how a mature technique can still be sharpened through measurement and repetition. Refer to this article for more information.

Follow to see more about Dr. Andrew Jacono on https://www.instagram.com/drjacono/?hl=en