How Dr. Andrew Jacono Built a Facelift Technique Surgeons Now Teach

A facelift used to mean one thing: tighter skin, pulled back until wrinkles disappeared, whether or not the result looked natural. Dr. Andrew Jacono set out to change that formula by working underneath the skin rather than stretching it, and two decades later the shift has reshaped how many surgeons approach facial rejuvenation.

Rebuilding the Foundation

His method targets the superficial musculoaponeurotic system, the tissue layer beneath the skin that connects to facial muscle. Traditional facelifts tighten this layer from above. Dr. Andrew Jacono instead releases the ligaments that anchor it and repositions the midface, jawline, and neck vertically, restoring the face’s original architecture instead of just smoothing its surface.

The result is what Dr. Jacono calls a ponytail-friendly facelift. Incisions run roughly a third the length of those used in older techniques, tucked behind the ear or along the hairline where hair pulled back cannot reveal them. Patients frequently describe the outcome as looking like a rested version of themselves rather than a surgically altered one.

From Case Studies to Classrooms

Jacono’s 2011 study in the Aesthetic Surgery Journal, covering 153 patients, gave the deep-plane approach its first strong footing in peer-reviewed literature. Since then, he has taught the technique, now referred to by some as the Jacono Method, through master classes and lectures delivered at international plastic surgery conferences, extending its reach well beyond his own operating room.

That teaching record matters because outcomes depend heavily on surgical skill. Deep-plane dissection sits closer to nerves and blood vessels than superficial techniques, and studies show it can actually lower the chance of nerve injury when performed correctly, since it preserves natural anatomical relationships rather than disturbing them. Patients who choose the technique also see results that last far longer than a conventional lift, with published outcomes spanning twelve to fifteen years. Refer to this article for additional information.

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