Two concerns dominate conversations about facelift surgery: how natural the results look and how long they last. Dr. Andrew Jacono built a technique specifically designed to address both, and in doing so attracted patients and surgical colleagues from around the world to his Manhattan practice.

The Architecture of the MADE Facelift

The Minimal Access Deep-Plane Extended facelift Dr. Andrew Jacono developed works at a level traditional techniques do not reach. Instead of tightening skin over the surface of the SMAS layer, the method dissects below it, keeping skin, muscle, and fat connected as a unified structure. This removes the primary source of tension that causes the stretched, operated look associated with older surgical approaches. Because the lift originates from deeper anatomy, the surface remains relaxed and natural in appearance.

The technique involves releasing four key facial ligaments that hold tissue anchored to bone. Over time, these ligaments loosen, allowing fat pads in the midface and neck to descend. Dr. Andrew Jacono’s method frees these attachments so the surgeon can move tissue vertically, working against the direction gravity has already pulled it. This addresses the mechanical cause of facial aging volume loss and downward migration rather than treating the skin as the primary problem. Research indicates the extended deep-plane approach lasts roughly twice as long as conventional SMAS techniques, a difference attributed to the depth and stability of the repositioning.

Small Incisions, Lasting Impact

One practical advantage of Dr. Andrew Jacono’s approach is incision length. The access points measure approximately one-third the size of those used in traditional facelifts, positioned along the hairline and behind the ear to remain concealed. Patients can wear their hair pulled back without visible scarring the origin of the term ponytail-friendly that has become associated with the procedure. Dr. Jacono published his initial outcomes in Aesthetic Surgery Journal in 2011 based on 153 patients, with complication rates including a 3.9% revision rate and 1.3% temporary facial nerve injury, both below industry averages. A 2019 paper added modifications targeting jawline contouring and lower-face volume. See related link for more information.

More about Dr. Andrew Jacono onhttps://www.youtube.com/c/drandrewjacono