Minimal Access Deep Plane Facelift Example 1:
Town and Country Magazine interviewed Dr. Jacono about his signature M.A.D.E. Facelift or Minimal Access Deep Plane Extended Facelift and how it differs from traditional SMAS facelift surgery.
Most people are afraid of a facelift because although they do not want a droopier face (cheek, jowls, and loosening and banding in the neck) for a tight appearing or stretched face often seen in traditional SMAS facelift surgery. He published this technique in the leading peer-reviewed plastic surgery journal the Aesthetic Surgery Journal.
Dr. Jacono’s technique differs because it lifts the skin, muscles, and fat pads of the face as a unit releasing the facial ligaments instead of peeling the skin away from its deep structure which puts tension on the skin and muscle layer of the face called the SMAS. It also utilizes an abbreviated incision behind the ear that allows his patients to wear their hair up in a ponytail. Town and Country Magazine suggests Dr. Jacono is one of the best facelift surgeons in the world and one of the first surgeons you should consider if you are thinking about a facelift.
Does Anyone Still Get a Face-Lift?
New techniques mean better results and far less recovery time than you might expect. Is it time to rethink the knife?
by Fiorella Valdesolo
Important to his technique is that the face is lifted vertically against gravity and not pulled back toward the ears which pulls the corners of the mouth. This vertical vector recreates the heart-shaped face of youth. He has conducted research looking at the vector of the facelift in two issues of the Aesthetic Surgery Journal called ‘The Angle of Maximal Rejuvenation in Facelift” and “The Optimal Vector in Facelift and Its Relation to the Zygomaticus Major Muscle.”
Dr. Jacono then performed a Meta-analysis looking at 40,000 patient outcomes that showed that the Deep Plane Facelift Complication rate of facial nerve injury is the lowest of all facelift techniques including SMAS plication, SMASectomy, high lateral SMAS, extended SMAS and composite facelift approaches, so it is an extremely safe technique. This study was also published in the Aesthetic Surgery Journal in 2019. He also published a study in JAMA Facial Plastic Surgery showing that using hyperbaric oxygen therapy after a deep plane facelift reduces the recovery by 50%.
In the article Dr. Jacono also discusses how fillers when overdone can actually stretch out the face causing it to droop more aggressively, and that many patients are opting for his MADE facelift in their forties, on average around 47. Even men are having facelifts more frequently now that it can be done with natural results. In his practice, men comprise 20% of his facelifts. The full article can be read below.
Minimal Access Deep Plane Facelift Example 2:
Minimal Access Deep Plane Facelift Example 3:
“There’s a particularly memorable scene in Terry Gilliam’s 1985 dystopian cult classic Brazil in which actress Katherine Helmond’s face is being pulled and prodded by a man in quasi-medical garb. “Just try to relax, and I’ll make you 20 years younger,” he says, laughing as he dramatically pins her skin back with binder clips and wraps it all taut with cellophane.
It’s a bizarre exaggeration, but it nails exactly what has long been the primary fear of anyone pondering a face-lift. “Everyone’s afraid of looking tight,” says New York plastic surgeon (and author of The Park Avenue Face) Andrew Jacono, alluding to that telltale stretched effect we all dread.
The traditional approach to face-lifting—one still employed by the vast majority of surgeons—involves separating the skin on the lower jaw from the muscle layer and hoisting it upward, thereby addressing the laxity of the jaw, jowls, and neckline that comes with age for most of us. “It makes your jawline tighter, but it can sometimes look like a beach ball on a popsicle stick,” Jacono says. It also can require the use of filler or fat grafting to fill out the cheeks, and it comes with the potential for noticeable scars and lengthy recovery periods.
Now there’s a wave of plastic surgeons cultivating a new, and decidedly more subtle, approach to the face-lift, fine-tuning techniques that are minimally invasive and require significantly less downtime (a week versus a month). One is Jacono’s MADE (minimal access deep-plane extended) procedure, which he calls a deep structural repair of the face, albeit one that remains “ponytail-friendly” (his incisions are a third the traditional length and are tucked far behind the ear).
Jacono keeps the skin, muscle, and fat together as a unit, and zeros in on the facial ligaments. “It’s like an ACL repair,” he says. “I release the ligament that gets stretched out, and the deep fat pads and muscles get repositioned vertically, so that makes the face look youthful and heart-shaped again.”
Minimal Access Deep Plane Facelift Example 4:
Minimal Access Deep Plane Facelift Example 5:
As surgery has evolved, so too has people’s relationship to procedures in general. Fillers and injectables such as Botox have redefined cosmetic surgery. Some surgeons believe that when used consistently over time, injectables can support needed volume while also minimizing the excess movement that can wear at the tissue, thereby putting off the need for surgery.
Jacono thinks that for substantial aging concerns, fillers have an expiration date. “When women start doing fillers in their late thirties and early forties, it accelerates the aging process,” he claims. “Fillers expand the facial tissue, so as you continue to use them you have to add more because the face gets looser, but that actually weighs the face down, making it look wider.”
Not only are people still going under the knife, but they’re also doing it younger than ever before. “The average age for a face-lift in my practice right now is 47,” Jacono says. The rise of social media may have helped provoke the shift by casting a new and omnipresent spotlight on appearance. But there has also been a gain in life expectancy, with people living and working longer and wanting to maintain their youthful look. Their results are often better as well since their skin is still better at their current age versus doing a facelift procedure when they are in their sixties.
It’s a trick that more men are signing up for as well; Jacono reports seeing a jump in male face-lifts from 2 percent of his procedures to 20 percent.
While injectables can lend themselves to overuse, a phenomenon sometimes referred to as “Instagram face,” the most dramatic aspect of the 2020 face-lift may be that it’s not that dramatic.”