A female patient being marked by surgeon before her facial plastic surgery

Deep Plane Facelift Surgery

The following information discusses the deep plane facelift procedure with New York’s Top Facial Plastic Surgeon, Dr. Andrew Jacono.

Deep Plane Facelift

The deep plane facelift avoids the problem of the tight, overfilled look of many modern facelifts. The main tenet of the procedure is that it lifts only under the muscle layer, leaving the skin attached to the muscle layers, so it can never look too tight. It also lifts the cheeks by releasing the tethering points of the face in the deep plane so that the addition of fat or filler is unnecessary.

What Is a Deep Plane Facelift?

The “deep plane” is the term used to describe the anatomic plane that exists between the SMAS-platysma complex (which is muscle and fascia) and the deeper layer of muscles responsible for facial expression. This procedure focuses on the release and movement of muscle and fat layers instead of skin pull and removal.

Deep Plane Facelift Patient Before and After Photo

Deep Plane Facelift Before and After

This patient had a Minimal Access Extended Deep Plane Facelift which is the signature M.A.D.E facelift procedure by Dr. Andrew Jacono. This patient was so thrilled with her results that she sent us her before and after photos that she took on her cell phone. This dramatic transformation has this patient looking 15 years younger.

Dr. Jacono is a facial plastic surgeon who has pioneered this technique and regularly lectures around the world from Tokyo, Paris, London, and Singapore, to Yale, Harvard, and Stanford University. Dr. Jacono has also published several books and articles on his developments in facelift procedures.

The deep plane facelift technique that Dr. Jacono has developed, incorporates the release of the ligaments tethering the deep plane layer to achieve tension-free movement so that no tightness can be created by the facelift procedure. He releases four ligaments with corresponding natural lifting throughout the face and neck.

The first ligaments released are the zygomatic ligaments that tether the cheek so that drooping cheeks can be elevated. This restores the cheek shape and volume, recreating the heart-shaped face of youth avoiding the need to add filler, fat, or cheek implants to the face. It also will improve the nasolabial folds (the creases from the nose to the corner of the mouth), and any hollowing and shadowing seen under the lower eyelids by restoring volume that is lost by gravitational descent associated with aging.

Dr. Jacono has published research in the Aesthetic Surgery Journal that this restores cheek volume equivalent to adding three vials of injected filler or fat in the face and that this effect is permanent. He releases the masseteric and mandibular ligaments that tether the jowl so that they can be lifted, creating a smooth and crisp jawline appearance.

How Does a Deep Plane Facelift Work?

Dr. Jacono was the first surgeon to describe the release of the cervical retaining ligaments that tether the platysma muscle in the neck – and this is the basis for his technique, the extended deep plane facelift.

This extension of the deep plane into the neck allows for more significant redraping of the platysma. Plus, rejuvenation and refinement in the neck and jawline are more natural and longer-lasting. This part of the technique also improves the definition along the angle of the jaw, which is often blunted by the bunching that is created in SMAS techniques.

Also unique to Dr. Jacono’s technique is the vector or direction in the face is lifted after the release is accomplished. A traditional facelift tightens the face horizontally or toward the ears and makes the face appear stretched and the cheeks flattened. This can also cause the corner of the mouth and eyes to look pulled.

To avoid these problems, a vertical vector or redraping is utilized. By lifting the face more vertically a smoother, more natural appearance is created, the cheeks are restored, and the corners of the mouth that sag with age are elevated.

Deep Plane Facelift Before and After

Deep Plane Facelift Before and After

This wonderful 54-year-old patient is pictured in the pre-operative area prior to her surgery and the after is her one year later out shopping and looking stunning! Her results are an example of how doing the right procedures, with finesse and balanced surgeries, to different areas of the face, can create a rejuvenating and natural result.

Deep Plane Facelift Video

This beautiful 54-year-old patient is shown in this cool video after her facelift with Dr. Jacono. The video starts in the pre-operative area the morning of her deep plane facelift surgery, and the after is 4 weeks post-surgery. The video is great because she does a 360 view of her face. Her result is an example of how doing the right procedures, finesse, and balanced surgeries on different parts of the face, create a natural and rejuvenating result.

Dr. Jacono’s Facelifting Expertise

Dr. Jacono performed clinical research that was published to better define the angle of the proper vertical vector or direction of the lift. He found the ideal vertical facelift – the “Angle for Maximal Rejuvenation” – to be 60 degrees for patients with a mean age of 60 years old. As the age of the patient increases, the angle decreases. Conversely, patients younger than 60 years old will require a greater, more vertical facelift angle.

Diagram of Deep Plane Facelift Illustrating How the Cheeks are Revolumized by Releasing the Zygomatic Ligaments
The above diagram shows how the cheeks are revolumized by releasing the zygomatic ligaments and repositioning the malar fat pads.

His Facelift Innovations

Another innovation in deep plane facelifting Dr. Jacono has introduced to the plastic surgery literature is the ability to perform this technique through a smaller incision. Often referred to as a Short Scar Facelift, Dr. Jacono’s hybrid technique is called a M.A.D.E.  or “Minimal Access Deep Plane Extended” facelift.

This approach leaves a scar that is half the length of a typical facelift scar. It is hidden inside the tragus and behind the ear so it cannot be visualized, even when the hair is pulled back or placed in a ponytail.

Deep Plane Facelift Ligament Diagram
This diagram shows the tethering points of the face that are released during a deep plane facelift procedure.

Combined with Necklifting

Depending upon the degree of neck drooping and heaviness that occurs, the surgery may be combined with a midline platysma tightening called a platysmaplasty. Through a small hidden incision under the chin, vertical cords and bands in the neck can be tightened and chin fat that accumulates with age can be removed. Because Dr. Jacono’s deep plane facelift more significantly lifts the platysma than other facelifting techniques, the additional midline surgery, trauma, and recovery can be avoided in a majority of cases.

Since the deeper layer utilized in a deep plane facelift is fibrous and inelastic, unlike the skin which is very elastic, the procedure has the most long-lasting result of any facelifting technique. Because it works on the structural elements of the face, it is more durable than SMAS-type facelifts, often lasting 10 years and beyond.

What is a Deep Plane Face and Neck Lift? And How Is It Different From a Deep Plane Facelift?

When considering facial rejuvenation, many patients get confused between what is a deep plane facelift and what is a deep plane neck lift. These questions are essential in understanding the options available for achieving a more youthful appearance.

Dr Jacono lectures on the deep plane facelift at the International Society of Aesthetic Plastic Surgery in Kyoto Japan
Dr. Jacono lectures on the deep plane facelift as a professor at the International Society of Aesthetic Plastic Surgery in Kyoto Japan.

A deep plane facelift is a sophisticated surgical technique that focuses on repositioning the deeper layers of facial muscles and tissues. This method provides a more natural and long-lasting result, reducing the appearance of sagging skin and deep wrinkles. The deep plane facelift procedure can offer a transformative effect on the mid and lower face.

On the other hand, a deep plane face and necklift is a comprehensive approach that combines the techniques of a deep plane facelift with specialized procedures for the neck area. It targets not only the face but also the underlying muscles of the neck, creating a smoother and more defined jawline.

So how is it different from a deep plane facelift? While a deep plane facelift primarily focuses on the face, the combined deep plane neck and facelift extend the rejuvenation to the neck area as well. This combined approach ensures harmony and balance between the face and neck, providing an overall more youthful appearance.

Complications and Expertise in Deep Plane Facelift Procedures

A deep plane facelift is an advanced surgical procedure focusing on lifting the deeper layers of muscles and connective tissue of the face and neck. It can rejuvenate drooping cheeks, jawline, and neck without a tight or unnatural appearance. This method differs from other facelift techniques by targeting deeper tissues, offering more natural and lasting results.

Deep Plane Facelift Complications

While deep plane facelift complications are rare, potential risks should be understood:

  • Nerve Damage: Among the most common complications, nerve damage occurs in fewer than 1% of patients when performed by a well-trained plastic surgeon.
  • Other Complications: As with any surgical procedure, there may be other risks such as swelling, bruising, or infection, though they are less common in deep plane facelift procedures.

Dr. Andrew Jacono: An Elite Plastic Surgeon

his expertise in deep plane face-lift techniques places him among the most elite plastic surgeons in the nation.

American facial plastic surgeon Dr. Jacono is considered by his peers to be one of the best deep plane facelift surgeons in the world.

Dr. Jacono has demonstrated his advanced deep plane facelift to plastic surgeons from all over the world in his state-of-the-art surgery center. In this picture, surgeons from Brazil, Portugal, Columbia, and Turkey are observing him perform a deep plane facelift.

  • Two Decades of Experience: His comprehensive technique helps create natural results by lifting drooping cheeks, jawline, and neck, often extending to a deep plane neck lift as well.
  • Published Research: He has multiple hallmark studies on his extended deep-plane technique in top publications like the Aesthetic Surgery Journal.
  • Educator and Speaker: Dr. Jacono has lectured at prestigious institutions like Harvard Medical School, Yale University, Stanford University, and the University of Pennsylvania. Furthermore, he’s delivered over 100 lectures at national and international plastic surgery symposia.

Choosing a skilled plastic surgeon like Dr. Jacono ensures that the deep plane face lift is performed with the highest level of precision, minimizing potential complications. His vast experience, coupled with innovative techniques, enables patients to achieve natural-looking results without the stigmas of tightness that may accompany other facelift methods.

Should you consider undergoing deep plane facelift procedures, understanding what a deep plane facelift is and consulting with a surgeon of Dr. Jacono’s caliber ensures that you are in expert hands. This offers peace of mind for those looking to rejuvenate their appearance and reverse the signs of aging with a deep plane facelift.

Natural Results with Consistency

Considered an international expert in deep plane facelifting, he was recently selected as one of the 20 best facelifting surgeons worldwide to contribute to a textbook comparing their expert methods in facelift surgery called Face the Facts.

He has performed over 1,500 procedures and continues to teach his techniques by performing live demonstration surgeries all over the world. Hundreds of surgeons from six continents have traveled to observe Dr. Jacono perform his signature technique.


Most patients are concerned about “looking like they had a facelift” or looking pulled after surgery because they’ve seen so many celebrities, newscasters, and people in their communities looking like they had work done.

Best Deep Plane Facelift Results

Deep Plane Facelift Before and After

This 56-year-old patient underwent a deep plane facelift, temporal lift, and lip lift in Istanbul for the ISAPS World Congress 2022. The procedure resulted in a significant improvement to her appearance, and the use of multiple techniques helped to create a more balanced and youthful look.

The reason for this is that the most commonly performed facelift surgery in the United States is a superficial facelift called a SMAS plication lift, not a deep plane facelift. This facelift technique involves simply elevating the skin followed by placing sutures to lift the SMAS-Platysma complex.

The Superficial Musculo-Aponeurotic System

The SMAS (Superficial Musculo-Aponeurotic System) is the muscle of the lower cheeks and jowl, and the platysma is the muscle that drapes across the neck and lower third of the face. Pulling this SMAS-Platysma layer is better than lifting the skin alone, but separating the skin from the underlying muscles as is performed in a SMAS facelift creates a tight look to the skin.

This surgery only treats the lower third of the face and jawline and does not lift drooping cheeks. As a result, many surgeons will perform fat grafting to the cheeks at the same time. Fat grafting is performed by liposuctioning fat from the abdomen or thighs and injecting it into the face, often making the cheeks look overfilled because they are not lifted as they droop and are simply inflated.

Unlike a SMAS facelift where the skin is separated from the deeper muscles and soft tissue, the deep plane technique re-positions under the loosened saggy muscles and fat of the face as a unit leaving the skin intact.

What Is Dr. Jacono’s Deep Plane Facelift Cost?

How much is a deep plane facelift?   The cost of a deep plane facelift is not an easy question to answer as every person is going to need specialized treatment and care. There is no single procedure with a set cost when it comes to deep plane facelifts.

You’ll note from the before and after pictures below, and the descriptions of the surgeries, that every deep plane facelift is different and there will be different needs special to each patient.

It’s important to remember that the money that you are investing into the deep plane facelift is literally going to affect the first thing people see when they meet you. Every time you greet someone and get a smile from them, you’ll know that the facelift from Dr. Jacono is doing its job. In other words, it’s an investment in yourself.

How Long Does it Take to Recover from a Deep Plane Facelift?

Recovery following a deep plane facelift usually involves some bruising and swelling around the re-positioned areas for the first few days. These symptoms will gradually disappear on their own.

Because the deep plane technique is accomplished in the layer that naturally exists in your face, there is minimal bruising and minimal pain after the procedure, in the days after surgery. Deep plane surgery also maintains more of the natural blood supply to the skin by not severing blood vessels between the muscle and skin, allowing for more rapid healing. SMAS-type facelifts lift under the skin and disrupt blood vessels. Because of this, bruising is greater in non-deep plane facelifts.

Some pain medication may be prescribed to help a patient to feel more comfortable during the healing process. Patients will also be encouraged to apply cold compresses to help alleviate swelling, and elevating the head will be recommended as well. It is important to get plenty of rest during the recovery.

How Long Before I Can Return to Work After a Deep Plane Facelift?

Returning to work after undergoing a deep plane facelift is a common concern for many patients. The deep plane facelift recovery period may vary from person to person and largely depends on individual healing rates and the nature of your work.

  • Consulting with Your Plastic Surgeon: Dr. Jacono will have a detailed understanding of your particular situation and will provide personalized guidelines. It is essential to follow his advice to ensure optimal deep plane facelift results.
  • Typical Recovery Time: Generally, most patients can expect to return to work about 10 to 14 days after surgery. This time frame allows for initial healing and reduction of any noticeable swelling or bruising.
  • Taking Care of Yourself: The deep plane facelift recovery process is crucial to achieving the best results. Adhering to post-operative care instructions and giving yourself time to heal will facilitate a quicker and more comfortable return to work.

Remember, every patient’s healing process is unique, and the exact number of days after surgery before you can return to work may vary. Consulting with Dr. Jacono and following his guidance is the best way to ensure a safe and successful recovery after your deep plane facelift.

Where are the Scars Located?

Deep Plane Facelift Before and After

Deep Plane Facelift Before and After

This before-and-after selfie was taken just three weeks after a live deep plane facelift surgery at the Baker Gordon Symposium on a 53-year-old patient from Arkansas. The results are stunning, and the patient looks gorgeous and natural, without any makeup.

Her facial rejuvenation included a deep plane facelift, upper and lower blepharoplasty, and a SMAS lip augmentation with a unilateral lip lift. The combination of these procedures has created a balanced and youthful look, and the patient is thrilled with the results.

Deep plane facelift incisions heal with minimal to no visible scarring. Because the deep plane facelift does not separate the skin and the lift is supported under the muscles, there is no tension or pulling on the incision lines once closed. This tension-free closure allows the incision to heal like imperceptible fine lines. It also prevents pulling of the earlobe after facelift which can create a “pixie ear” deformity where the earlobes are elongated and are pulled down after traditional facelift surgery.

Is A Deep Plane Facelift Better?

There are many advantages to having Dr. Jacono perform your deep plane facelift. As a pioneer and teacher of this surgical procedure, Dr. Jacono has developed improvements that his patients benefit from.

To begin with, Dr. Jacono uses local or twilight anesthesia to perform the deep plane facelift, which allows him to keep the surgical time around 1 ½ to 2 hours long. Often patients will have an awake deep plane facelift with just numbing shots in the face using medication like Novocaine that may be used at the dentist. There is also less trauma caused to the facial tissue, so the recovery time is also shorter.

A standard facelift procedure involves general anesthesia and surgical time that can last up to 5 hours.

An overview of some benefits includes:

  • Shorter surgical time
  • More natural results by repositioning the SMAS platysma
  • Restoration of natural volume and elevation of the cheeks
  • Excess skin is removed leaving smoother skin
  • Nasolabial folds are softened
  • Quicker recovery
  • Less noticeable facelift scars
  • Longer lasting result

Who is a Good Candidate?

Good candidates for a deep plane facelift are men and women who are showing signs of aging in their faces, including sagging and drooping skin. Candidates should be in good physical health and have realistic expectations of the surgical outcome. During your consultation with Dr. Jacono, he will be able to determine if a deep plane facelift is the right procedure for you.

Looking for a deep plane facelift near me? A deep plane facelift in New York City? Or have more questions about the deep plane facelift? To learn more about the deep plane facelift or to schedule a  consultation, contact Dr. Jacono today at 212-570-2500.

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Deep Plane Facelift Before and After Photos

Deep Plane Facelift Patient Before and After Patient 1:

This wonderful 57-year-old patient was unhappy with her facial aging. I performed an extended deep plane facelift, a neck lift, and platysmaplasty with neck liposuction which gave her back a crisp yet smooth and natural-looking jawline. She was excited about her results and extremely happy that she had her scars that were already almost gone. Even with her hair pulled back into a ponytail, you will not be able to see any visible scarring.

Before & After
Extended Deep Plane Facelift Results Before and After
Before & After
Extended Deep Plane Facelift Results Before and After

Deep Plane Facelift Patient Before and After 2:

This amazing 75-year-old patient of mine is just 6 months out following her facial plastic surgery. This patient was concerned with her aging and did not like the loose hanging neck skin or her jawline. To reverse this, I performed an extended deep plane facelift procedure combined with a neck lift, platysmaplasty, and a lip lift.

The lip lift is the icing on the cake as it shortened the distance between the base of the nose and the top of her upper lip. This brings the aesthetic balance of the face together which includes a gorgeous jawline and smooth neck. She looks rejuvenated and refreshed, naturally.

Before & After
Extended Deep Plane Facelift Patient Before and After Photos
Before & After
Extended Deep Plane Facelift Patient Before and After Photos

Deep Plane Facelift & Platysmaplasty Before and After 3:

This 53-year-old woman wanted to refresh her appearance while still looking natural. To accomplish this task, Dr. Jacono performed a combination of procedures which included his deep plane facelift technique which addressed her fallen cheeks, nasolabial folds, and jowls. A fat transfer (fat grafting) restored her temples and cheeks.

To smooth her neck and reduce the appearance of her neckbands (platysma bands), Dr. Jacono performed a neck lift with platysmaplasty. For the upper portion of her face, he performed a lower blepharoplasty to reduce her eyebags and a lateral temporal lift for her upper eyebrows to reduce her tired appearance.

To complete the overall facial rejuvenation, Dr. Jacono performed a lip lift to reduce the distance between the bottom of her nose and her upper lip. She loves her results and feels that she looks natural and refreshed.

Before & After
Side View of Deep Plane Facelift Before and After
Before & After
Side View of Deep Plane Facelift Before and After

Deep Plane Facelift Patient Before and After 4:

This wonderful 50-year-old patient easily looks like she is in her thirties following her facial plastic surgery with Dr. Andrew Jacono. To accomplish this, Dr. Jacono re-balanced her face with a deep plane facelift, lateral temporal lift, lower eyelift, fat grafting, a necklift with platysmaplasty, and importantly a revision rhinoplasty for the nasal tip.

Before & After
Deep Plane Facelift Results
Before & After
Deep Plane Facelift Before and After

Deep Plane Facelift Before and After – Patient 5:

This patient, who is 59 years old, underwent a deep plane facelift six months ago and her transformation is simply stunning. The combination of various procedures carried out with finesse and balance on different parts of her face has resulted in a rejuvenating effect.

The treatments included a deep plane facelift, neck lift, platysmaplasty, browlift, lower blepharoplasty, buccal fat removal, fat grafting, and lip lift. The brow lift and lower eyelid lift have given her a youthful and arched brow, while removing forehead and eyelid wrinkles.

The deep plane facelift has lifted her cheeks, smoothed out nasolabial folds and jowls. Buccal fat removal has reduced the fullness of her lower face. The platysmaplasty has created a crisp and well-defined neck. The final touch, the lip lift, has further enhanced her appearance.

Before & After
Deep Pane Facelift Before and After Photo
Before & After
Deep Pane Facelift Before and After Photo

Deep Plane Facelift Patient Before and After – Patient 6:

At 71 years of age, this patient looks absolutely stunning, just four weeks after her facial plastic surgery and one week after her birthday. Her transformation highlights how the use of multiple procedures on the upper, middle, and lower parts of the face can create a beautiful, balanced, and youthful appearance.

Before the surgery, she was concerned about her sagging jawline, jowls, fallen cheeks, and platysma bands. To address these concerns, she underwent a deep plane facelift, neck lift, and platysmaplasty, which helped to redefine her jawline and create a more defined neck.

Before & After
Deep Plane Facelift Photos
Before & After
Deep Plane Facelift Photos

Deep Plane Facelift Before and After – Patient 7:

This beautiful 61-year-old patient was unhappy with her facial appearance. She felt she still looked droopy and had very visible scars from a prior surgery with a different surgeon. She hated her dropping jawline, jowls, fallen cheeks, and platysma bands, as well as her tired eye appearance.

Dr. Jacono performed a deep plane facelift, necklift, and platysmaplasty for her face and neck. He also performed a temporal lift to open her upper eyelids, and a lower blepharoplasty for lower eyelid bags and tired looking eyes. She looks at least 20 years younger in her after photos.

Before & After
Deep Pane Facelift Before and After Photo
Before & After
Deep Pane Facelift Before and After Photos

Deep Plane Facelift Before and After – Patient 8:

This patient was unhappy with the loose, excess skin and wrinkles on her face and neck. She wanted to smooth out her facial wrinkles including under her eyes and neck region. She also wanted to reduce the appearance of her jowls and nasolabial folds, which she felt were making her look older.

Dr. Jacono performed a deep plane facelift to reduce the appearance of her sagging jowls and to lift her cheeks naturally. He also performed a neck lift to address the loose hanging neck skin, and he performed a lower eyelid lift procedure. The after photos show her looking natural and 20 years younger.

She does not look like she had any type of cosmetic procedure and her family and friends have all told her that she looks terrific.

Before & After
Deep Pane Facelift Before and After Photos
Before & After
Deep Pane Facelift Before and After Photos

Deep Plane Facelift Before and After – Patient 9:

This wonderful 53-year-old patient was unhappy with how she was aging. She did not like how her cheeks had fallen, the appearance of jowls, and how she always looked tired.

Dr. Andrew Jacono performed his signature deep plane facelift procedure combined with a neck lift to address her concerns. He also performed an eyelid lift with a lateral temporal lift to open her eyes and appear less tired. She loves how natural and awake she looks.

Before & After
Deep Plane Facelift Before and After 50 Year Old
Before & After
50 Year Old Deep Plane Facelift Patient Photos

Deep Plane Facelift Before and After – Patient 10:

This 60-year-old female patient wanted to look more youthful and refreshed. Dr. Jacono performed a deep plane facelift with a platysmaplasty to address her concerns. She looks beautiful and natural with a smooth neck and jawline.

Before & After
Deep Plane Facelift New York
Before & After
Deep Plane Facelift New York

Deep Plane Facelift Before and After – Patient 11:

This patient underwent a deep plane facelift lifting the drooping muscles of the jowl and neck through a short incision often called a short scar facelift. Dr. Jacono used endoscopes through these smaller incisions to limit scarring. She also had a lip lift at the same time and lip augmentation using SMAS Muscle. A Fat transfer performed to her temples and under her eyes to complete the transformation.

Before & After
Deep Plane Facelift Patient Before and After Photos
Before & After
Deep Plane Facelift Patient Before and After Photos

Deep Plane Facelift Before and After – Patient 12:

This patient is a woman in her late fifties who wanted to restore a more youthful jawline, lift her hanging neck and chin, and smooth vertical platysma bands under her neck. After her surgery, she looks natural and not tight because Dr. Jacono performed a deeper procedure that lifts under the muscles and does not stretch the skin.

Before & After
Deep Plane Facelift Before and After
Before & After
Deep Plane Facelift Before and After

The photographs above are before and after photos of Dr. Jacono’s Deep Plane Facelift patients. These are actual results and have not been altered for presentation here.

More Deep Plane Facelift Photos

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