Ask ten facial plastic surgeons how a facelift works and most will describe some version of the SMAS technique, separating skin from the superficial musculoaponeurotic system and pulling the skin taut. Dr. Andrew Jacono trained in that method before building an alternative around it.

The SMAS approach has been a facelift standard for years. Surgeons lift and tighten the skin layer independently, which produces visible improvement but leaves the deeper facial architecture largely as it was. Results from that method commonly last six to eight years before gravity and tissue laxity bring back the original signs of aging.

A Different Structural Logic

Dr. Andrew Jacono’s Minimal Access Deep-Plane Extended facelift instead operates below the SMAS layer entirely. Rather than treating skin and muscle as separate surfaces to manipulate independently, the technique repositions them as one unit, releasing the ligaments that anchor tissue to bone along the way.

This distinction is not cosmetic terminology. It changes what the surgery is actually correcting. Instead of tightening skin over an unchanged foundation, the procedure rebuilds the foundation itself, lifting descended fat in the midface, jawline and neck vertically rather than pulling skin backward.

A Track Record in Practice

Jacono has performed the technique at his Manhattan practice for roughly two decades, averaging about 250 extended deep-plane procedures annually. He first documented outcomes formally in 2011 through the Aesthetic Surgery Journal, reporting results from 153 patients.

For patients comparing options, understanding this distinction between surface-level tightening and structural repositioning can clarify why recovery experiences and longevity vary so widely between facelift techniques.

Cost and recovery time are often the first questions patients raise, but the more useful question is what the surgery is actually correcting underneath the skin. A technique that only tightens surface tissue will eventually contend with the same downward pull that caused the original sagging, while one that repositions deeper structures addresses that force more directly.

Surgeons who perform both techniques regularly are generally best positioned to explain these trade-offs honestly, rather than favoring whichever approach they happen to be more familiar with. Visit this page on Youtube, for additional information.

Learn more about Dr. Andrew Jacono on https://www.bbntimes.com/science/what-peer-recognition-and-national-rankings-reveal-about-dr-andrew-jacono-s-surgical-reputation