Facelift incisions have historically been one of the procedure’s most visible drawbacks. Long cuts running through the hairline, around the ear, and down the neck left patients with evidence of their surgery that restricted hairstyle choices for months and sometimes years. Patients who chose shorter haircuts or updos risked visible scarring, which undermined the goal of a naturally refreshed appearance. The extended deep-plane technique developed by Dr. Andrew Jacono addressed this problem as a byproduct of its broader departure from conventional facelift mechanics.

Because Dr. Andrew Jacono’s technique repositions the underlying tissue composite rather than relying on skin tension for lifting, the skin requires less manipulation and far less access than traditional approaches demand. Incisions in his method measure approximately one-third the length of those used in conventional facelifts. They are placed behind the ear or along the natural hairline, in positions that remain hidden even when patients wear their hair pulled back. Dr. Jacono uses the term ‘ponytail-friendly’ to describe this outcome a practical standard that reflects real daily use rather than a clinical abstraction.

Minimal Scarring Alongside Comprehensive Outcomes

The shorter incision profile is not the only advantage the technique offers. Dr. Andrew Jacono’s published research documents a clinical profile that outperforms industry averages across multiple measures. His 2011 Aesthetic Surgery Journal study of 153 patients reported a 3.9% revision rate, approximately 1.9% hematoma rate, and 1.3% incidence of temporary facial nerve injury. Later research confirmed that operating deeper in the face actually preserves anatomical relationships and reduces nerve injury risk relative to superficial approaches.

Results hold for 12 to 15 years, compared to roughly half that span for standard SMAS procedures. Dr. Andrew Jacono performs approximately 250 procedures per year, and his 2021 medical textbook synthesizes technical lessons from over 2,000 cases into a framework that surgeons worldwide apply in training. The combination of minimal visible scarring, low complication rates, natural appearance, and long-lasting durability defines the technique’s full clinical value. Read this article for more information.

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