Most surgical approaches to facial aging treat its most visible feature: loose, descending skin. Dr. Andrew Jacono built his reputation on a different premise that durable rejuvenation requires addressing the structural changes happening beneath the surface, not just smoothing what is visible from the outside.
The Minimal Access Deep-Plane Extended facelift developed by Dr. Andrew Jacono operates below the SMAS layer, the sheet of muscle and connective tissue that overlies the deeper facial anatomy. Standard facelifts separate skin from the SMAS, reposition each independently, and rely heavily on surface tension to hold results in place. The MADE technique keeps these layers united, moving them together as a single anatomical unit. This preserves blood supply, reduces the tension that creates an artificial appearance, and allows for vertical repositioning of tissue descended through years of gravitational pull.
Ligament Release and Volume Restoration
Central to Dr. Jacono’s method is the release of four facial retaining ligaments that anchor tissue to underlying bone. These ligaments, as they loosen with age, allow fat pads in the cheeks, jowls, and neck to drift downward. By releasing and repositioning these structures, surgeons can restore midface volume and jawline definition without injecting filler or grafting fat. The procedure essentially moves descended tissue back to its anatomical origin. Dr. Andrew Jacono published research showing this restoration equates to approximately three vials of injectable filler without any augmentation material whatsoever.
A Track Record Built in the Operating Room
Dr. Andrew Jacono introduced the technique in the early 2000s and first documented it formally in a 2011 publication in Aesthetic Surgery Journal covering 153 patients. He performs roughly 250 extended deep-plane facelifts per year in Manhattan and has taught the methodology at over 100 international conferences. His 2021 medical textbook compiled insights from more than 2,000 facelift procedures, offering the surgical community a detailed record of the technique’s development. Incisions measuring approximately one-third of conventional facelift scars remain hidden along the hairline and behind the ear a practical detail that matters considerably to patients navigating post-surgical visibility. Visit this page for related information.
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