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Home » Plastic Surgery Results » Facelift » Deep Plane Facelift

Deep Plane Facelift Plastic Surgery

Deep Plane Facelift in NYC

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 avoids the problem of the tight, overfilled look of many modern facelifts. The main tenet of the deep plane facelift 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.

The extended deep plane facelift 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.

best 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.

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 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.

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.


deep plane facelift cheek lift
The above diagram shows how the cheeks are revolumized by releasing the zygomatic ligaments and repositioning the malar fat pads.


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 or S-lift type incision, Dr. Jacono’s hybrid deep plane facelift is called a M.A.D.E.  or “Minimal Access Deep Plane Extended” facelift.

This approach leaves a deep plane facelift 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
This diagram shows the tethering points of the face that are released during a deep plane facelift procedure.


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.

Depending upon the degree of neck drooping and heaviness that occurs, the deep plane facelift 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 extended 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 deep plane facelift procedure has the most long-lasting result of any facelifting technique. Because it works on the structural elements of the face, the deep plane facelift is more durable than SMAS type facelifts, often lasting 10 years and beyond.

Deep plane facelift complications are rare. The most common complications from the deep plane facelift include nerve damage in the face, but studies have shown that this occurs in fewer than 1% of patients when the doctor is well-trained. You can rest assured that Dr. Jacono is one of the most elite plastic surgeons in the nation. For more information about Dr. Jacono’s credentials, read below.

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.

Over the course of almost two decades, Dr. Andrew Jacono has developed and pioneered the most advanced and comprehensive deep plane facelift that helps create natural results by lifting drooping cheeks, jawline and neck without the appearance of the stigmata of tightness that can occur with other facelifting techniques. Dr. Jacono has published multiple hallmark research studies on his extended deep plane facelift technique in the Aesthetic Surgery Journal, the leading peer-reviewed plastic surgery publication of the American Society of Aesthetic Plastic Surgeons.

He has given lectures on deep plane facelifts at Harvard Medical School, Yale University, Stanford University, and the University of Pennsylvania. He has also delivered over 100 lectures on his extended deep plane facelift at the most important national and international plastic surgery symposia of the American Academy of Facial Plastic and Reconstructive Surgeons, the European Academy of Facial Plastic Surgeons, and the International Society of Aesthetic Plastic Surgeons.

He is considered an international expert in deep plane facelifting, and was recently selected as one of the 20 best facelifting surgeons worldwide to contribute to a textbook comparing their expert methods in facelift surgery.

He has performed over 1,500 deep plane facelifts 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.

Deep Plane Facelift vs. SMAS Facelift

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.

dr jacono extended deep plane facelifting textbook
Dr. Jacono Deep Plane Facelift Technique

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 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? It’s 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 be affecting 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. 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.

Where are the Scars for a Deep Plane Facelift?

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 for a Deep Plane Facelift?

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.

Deep Plane Facelift Before and After Photos


Deep Plane Facelift Patient Before and After 1:

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
best deep plane facelift surgeon world
Before & After
deep plane facelift before and after


Deep Plane Facelift Before and After – Patient 2:

This beautiful 61-year-old patient was unhappy with her facial appearance. She felt she still looked droopy and had very visible scars from aprior 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
best deep plane facelift surgeon nyc
Before & After
best deep plane facelift before after


Deep Plane Facelift Patient Before and After – Patient 3:

This middle-aged woman had a deep plane facelift procedure performed by Dr. Jacono to lift her cheeks, jowls, and neckline. Minimal incision techniques were used to create a natural facial rejuvenation with no visible scarring.

Before & After
deep plane facelift before after photos
Before & After
deep plane facelift before and after patient photos


Deep Plane Facelift Before and After – Patient 4:

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 plane facelift before and after photos
Before & After
deep plane facelift before and after photos


Deep Plane Facelift Patient Before and After – Patient 5:

Unhappy with her sagging jawline, neck, and eyelids, this patient opted for a deep plane facelift combined with a lower blepharoplasty with Dr. Andrew Jacono. The before and after photos show her stunning jawline and tight neck area. It is also apparent that her cheeks have been lifted and her lower eyelids no longer look droopy and tired. Her overall facial rejuvenation shaved years off of her age and she looks beautiful and refreshed.

Before & After
best deep plane facelift results
Before & After
best deep plane facelift photos


Deep Plane Facelift Before and After – Patient 6:

This lovely patient had a prior facelift procedure with another surgeon two years earlier. She was unhappy with the results as her cheeks were overfilled and her jowls were still visible. She felt her facial contour was lumpier, rather than smooth.

To correct this, Dr. Andrew Jacono performed a revision facelift procedure using his deep plane technique which lifts the cheeks and nasolabial folds to their natural position while smoothing the jawline. To complete the transformation, a lateral temporal lift was used to open the upper eyelids and outer brow, so she did not look tired anymore.

She loves her new refreshed look and looks natural even without makeup.

Before & After
best deep plane facelift before and after
Before & After
best deep plane facelift surgeon america


Deep Plane Facelift Before and After – Patient 7:

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
best deep plane facelift before and after 50 year old


Deep Plane Facelift Before and After – Patient 8:

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 face lift newyork
Before & After
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Deep Plane Facelift Before and After – Patient 9:

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 before and after photos
Before & After
deep plane facelift before and after photos


Deep Plane Facelift Before and After – Patient 10:

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 after
Before & After
deep plane facelift before 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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Mission Statement

Doctor Jacono’s desire to become a facial plastic surgeon was solidified in grade school. There was a girl on his school bus route who was born with a cleft lip and palate deformity. Unfortunately, whenever she spoke, air and words escaped through her nose. Kids teased her and were cruel, and nobody would sit next to her on the bus, so he decided to sit with her. One day, the girl had plastic surgery and returned to school with her face repaired. Suddenly, classmates saw her face instead of her deformity and immediately treated her normally. It was at that moment that Doctor Jacono knew he wanted to fix people’s faces and change their lives. This is why he has gone on over twenty plastic surgery missions to poor countries around the world and provided free cleft lip and surgery for birth defects to over 500 children.

Because of this experience in his childhood, Doctor Jacono understands that one of our basic needs as human beings is to feel confident about our appearance. It’s is Doctor Jacono’s passion to help his patients achieve their facial aesthetic goals, creating natural appearing results to either enhance their beauty and proportion or rejuvenate their aging appearance. He is a world-renowned leader in the field of facial plastic surgery and only performs surgery on the face, not the body. He has innovated many facelift, eyelid lift, and rhinoplasty surgical techniques, publishing in leading peer reviewed literature and lecturing at plastic surgery conferences all over the world. He is committed to sharing what he has learned teaching surgeons from around the world.

His approach is to maintain your uniqueness and facial identity; it is still you just better. To do this he uses a customized, bespoke approach to each patient employing the most minimally invasive, innovative, and cutting-edge technology. Doctor Jacono has never performed the same procedure on any two of the thousands of patients he has treated. He is committed to providing his surgical expertise in a caring, supportive environment with a professional staff that has you as their focus and concern.