The phrase ‘gold standard’ gets applied loosely in medicine, but in facial plastic surgery it has a specific and defensible meaning when attached to the extended deep-plane facelift. The technique pioneered by Dr. Andrew Jacono earns that designation not through marketing but through peer-reviewed outcome data, reduced complication rates, documented longevity, and a growing body of surgeons trained in its execution.

What Sets the Extended Deep Plane Apart

Conventional facelifts address the surface. The extended deep-plane facelift addresses the structure beneath it. Dr. Andrew Jacono works below the SMAS layer, releasing the facial retaining ligaments that hold descended tissue in place. Once released, the composite flap skin, fat, and muscle connected as one unit can be repositioned vertically without the tension that causes distortion in skin-only lifts. The midface regains volume, the jawline sharpens, and the neck smooths, all while incisions remain approximately one-third the length of those used in traditional procedures.

Dr. Jacono published his foundational outcomes study in Aesthetic Surgery Journal in 2011, drawing on 153 patient cases. The data showed a 3.9% revision rate, roughly 1.9% hematoma rate, and 1.3% temporary facial nerve injury numbers that placed the method well below the field’s baseline complication benchmarks. Further research confirmed that the deeper dissection plane actually reduces facial nerve injury risk compared to superficial techniques, because anatomical relationships and blood supply are better preserved throughout the procedure.

Results That Hold Over Time

Outcome longevity distinguishes the extended deep-plane approach from alternatives more than almost any other variable. Dr. Jacono’s published data document results lasting 12 to 15 years, roughly double what standard SMAS facelifts achieve. That difference matters to patients planning a single, definitive intervention rather than periodic maintenance procedures. The textbook Dr. Jacono published in 2021, The Art and Science of Extended Deep Plane Facelifting, distills those findings into a clinical reference that trains new surgeons and documents the evolution of a method that Dr. Andrew Jacono has refined across more than 2,000 cases. Read this article for more information.

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