Most facelift surgeries avoid touching the ligaments that anchor facial tissue to bone. Dr. Andrew Jacono’s technique is built around releasing those ligaments and that decision accounts for much of what distinguishes his extended deep-plane results from what conventional procedures can achieve.

Why Ligaments Are Central to the Outcome

Facial retaining ligaments are the fibrous connections that hold the fat pads and soft tissue of the face fixed to underlying bone. Over time, as those fat pads lose volume and descend with gravity, the ligaments keep them tethered in their lower position. Standard facelift techniques work above or at the SMAS layer, which means these anchors remain intact. Whatever tissue repositioning the surgery achieves has to work against that resistance. Dr. Andrew Jacono releases four key retaining ligaments during the MADE facelift, which allows the midface fat pads, jowl tissue, and neck structures to be moved vertically back toward their original positions without the strain that creates surface tension and the pulled look many patients want to avoid.

Documented Results With Below-Average Complication Rates

When Dr. Andrew Jacono published the first outcomes data for his technique in Aesthetic Surgery Journal in 2011, the 153-patient study showed complication rates that fell below industry norms. Later research has reinforced that finding, confirming that deep-plane dissection carries lower facial nerve injury risk than superficial approaches because the anatomy at that depth better preserves the structural relationships that protect nerve function. The approach also keeps skin connected to muscle and fat throughout surgery, which maintains blood supply and reduces healing time. Incisions run roughly one-third the length of conventional facelifts. Results last approximately twice as long as standard SMAS procedures. Dr. Jacono’s 2021 medical textbook, drawing on more than 2,000 cases, gave surgeons a detailed reference for applying the methodology. He performs around 250 extended deep-plane facelifts per year from his Manhattan practice. See related link for more information.

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