Surgical techniques pass through an informal vetting process before reaching textbook status. Early adopters test the method, outcomes are published, complications are documented, and peers evaluate the data independently. Only when a technique demonstrates consistent reproducibility does it earn formal codification. The extended deep-plane facelift cleared that threshold in 2021 when Dr. Andrew Jacono published The Art and Science of Extended Deep Plane Facelifting. The book draws on insights from more than 2,000 procedures and documents the technical foundations and anatomical considerations that define his approach.

The technique operates beneath the superficial musculoaponeurotic system, releasing retaining ligaments and repositioning the composite tissue unit of skin, fat, and muscle as a single structure. Traditional facelifts tightened the SMAS from above without releasing the anchoring ligaments, leaving the deep structural changes of aging unaddressed. Dr. Andrew Jacono’s approach corrects this at the source, which is why his textbook needed to cover anatomy, ligament release, and vertical repositioning rather than simply surface-level skin management.

What the Textbook Covers

The publication addresses the midface, jawline, and neck, explaining how vertical tissue repositioning produces different and more lasting outcomes than horizontal skin tension. Dr. Andrew Jacono’s textbook serves as a training resource for surgeons who attend his master classes at international conferences or who study the technique independently. The goal is not just documenting his own outcomes but establishing a framework that other surgeons can adopt and reproduce.

The clinical foundation behind the textbook is substantial. Dr. Andrew Jacono published his first peer-reviewed study in Aesthetic Surgery Journal in 2011, documenting 153 cases with complication rates below industry standards: 3.9% revision, approximately 1.9% hematoma, and 1.3% temporary facial nerve injury. Results last 12 to 15 years, about twice the durability of standard facelifts. Performing roughly 250 procedures each year, Dr. Jacono maintains the case volume that produces both ongoing technical refinement and the detailed clinical data a surgical textbook demands. Refer to this article for related information.

Watch for more about Dr. Andrew Jacono on https://www.youtube.com/c/drandrewjacono