The State of the Modern Facelift
Ever since its inception, the facelift has been one of the most popular and yet hotly contested solutions to ungraceful aging. The first-ever facelifting technique, the traditional facelift, is an invasive four-hour procedure that pulls the skin taut without significantly manipulating the underlying facial anatomy comprising muscles, ligaments, and connective tissue.
The result of a traditional facelift tends to be a wrinkle-free appearance that, while undeniably impressive, happens to look somewhat unnatural.
“The traditional facelift certainly gets rid of wrinkles and saggy skin,” explains Dr. Jacono, “but it also leaves a lot of people—Mickey Rourke, Jocelyn Wildenstein, and Joan Rivers included—looking ‘tight’ and ‘pulled.’ Of course, when people began to see these sorts of strange results, they became distrustful of the facelift and of plastic surgery more generally.”
This taboo has persisted for many years, about which most aesthetic surgeons are understandably unhappy but largely unable to fix. Luckily, however, a select few cosmetic masters have taken the facelift to new heights; in fact, the Extended Deep Plane Facelift, the current gold standard of facelifting, was pioneered and perfected by Dr. Jacono himself. It is such an outstanding procedure that, in July of 2021, fashion mogul Marc Jacobs booked a surgical slot with Dr. Jacono and documented his recovery process on Instagram. The response was overwhelmingly positive, due in no small part to the fact that he looked just like himself, but twenty years younger.
“I’m incredibly impressed with Marc’s transparency,” says Dr. Jacono. “So many celebrities have lied about their surgical experiences, which has made a lot of people feel like getting work done is bad, but the truth that Marc has highlighted is that it’s possible to get tweaks without looking distorted.”
So, what exactly differentiates the Extended Deep Plane Facelift from other procedures?
It’s All in the Details—and the Muscles
Dissatisfied with the results of the traditional facelift, surgeons developed the SMAS Facelift, which targets a deeper layer of tissues, ligaments, and muscles known as the SMAS (Subcutaneous Muscular Aponeurosis System. The SMAS, along with overlying skin, is cut and stretched over the neck, the cheeks, and the jawline. This smooths the jowls and nasolabial folds and even does away with persistent problems like turkey necking. Compared to the traditional facelift, the SMAS Facelift provides better and more consistent results, not to mention a shorter recovery time.
The problem with the SMAS Facelift, however, is that despite its obvious improvements, it can still make patients look “pulled.”
“For the most part, the SMAS Facelift is a good technique,” says Dr. Jacono, “but it still requires the excision of skin and the stretching of muscles that don’t necessarily need to be stretched.”
To address the failings of the SMAS Facelift, Dr. Jacono decided to go deeper, and quite literally; he set his sights on the face’s “deep plane,” the muscular architecture largely responsible for facial expression. Rather than stretching the deep plane and risking an unnatural-looking outcome, Dr. Jacono makes a short incision along the face’s natural creases before lifting specific pockets of fat, muscle, and tissue to a more desirable vertical position.
“Essentially, I’m sculpting,” says Dr. Jacono. “What’s great is that this technique allows me to re-create that sort of full, appley cheek without the need for injections like Botox or Juvéderm.”
This impressive facelift boasts a recovery time of only 10 or so days, which can be further shortened by hyperbaric oxygen therapy and Vbeam laser treatment. Even better, the Extended Deep-Plane Facelift lasts between 12 and 15 years, after which patients will still look better than they did when they initially came in for their surgical consultation.
How Common is the Extended Deep-Plane Facelift?
Because the Extended Deep-Plane Facelift is an incredibly complex, cutting-edge procedure, there are only a handful of surgeons who have mastered the technique and offer it in practice.
“The truth is that the Extended Deep-Plane Facelift is tough to learn, requires a lot of practice, and demands a sharp aesthetic eye,” explains Dr. Jacono. “At the moment, I’m one of the few surgeons in the world who is confident enough to perform multiple Deep-Plane Facelifts a week.”
Dr. Jacono doesn’t want this dearth of qualified facial plastic surgeons to persist, though—in 2020, he published a 500-page textbook on the nuances of the technique.
“I want every doctor to be doing a better job,” he says. “If they were, people wouldn’t be so hesitant about getting a facelift and looking their absolute best.”