Dr. Andrew Jacono’s Approach to Comprehensive Facial Rejuvenation

The patient who walks into a facial plastic surgeon’s office today rarely wants a single thing fixed. They want to look rested. They want their jawline back. They want skin that matches the structural work underneath. For Dr. Andrew Jacono, a dual board-certified facial plastic surgeon based in New York, that broader picture is where the clinical work actually begins.

Comprehensive rejuvenation is a clinical framework, not a marketing phrase. Faces age across multiple dimensions simultaneously – tissue descends, volume depletes, and skin quality deteriorates. Addressing only one of those factors produces results that read as incomplete, or worse, mismatched. The structural lift that produces a well-defined jawline but leaves surface sun damage untouched tells its own story. Dr. Jacono’s practice treats those variables as connected, not separate.

Jawline and Neck Anatomy Cannot Be Separated

The extended deep-plane approach that Dr. Jacono introduced and published in Aesthetic Surgery Journal in 2011 addresses the midface, jawline, and neck as part of a unified anatomy. Where standard facelifts tighten skin in isolation, the deep-plane method releases key facial ligaments and repositions underlying fat pads vertically, restoring the structural support that gives the lower face its definition.

A 2019 paper in Aesthetic Surgery Journal introduced his “mandibular defining line” measurement, a quantitative tool for evaluating jawline volume and contour improvement following extended deep-plane facelifts. The study provided objective evidence that deep tissue repositioning, rather than surface manipulation, drives durable changes in jawline definition. Deep-plane dissection also carries a lower risk of facial nerve injury compared to more superficial techniques, because preserving the anatomical relationship between tissue layers protects the nerves that control facial expression.

Results from the extended deep-plane facelift can last 12 to 15 years. Key factors that affect the longevity of the extended deep-plane facelift include technique, lifestyle, skin quality, and care. Dr. Andrew Jacono performs approximately 250 deep-plane facelifts annually at his Park Avenue practice in New York, a volume that sustains the clinical precision the technique requires.

Skin Quality Is Part of the Surgical Plan

Structural repositioning establishes the foundation. What patients see in the mirror is also determined by what sits on top of that foundation: the texture, tone, and quality of the skin itself. Dr. Jacono incorporates fractional CO₂ laser resurfacing as part of a comprehensive treatment plan when skin surface concerns warrant it, improving texture and stimulating collagen production in the same operative window as the facelift.

The case for combining modalities is straightforward. A patient whose tissue has been properly repositioned but whose skin carries years of sun damage, uneven pigmentation, or surface irregularities will not achieve the same visual outcome as one whose skin quality matches the structural work. Treating both within the same plan reduces overall recovery time and produces results with greater coherence.

Peer Recognition Built on Published Evidence

Harper’s Bazaar selected Dr. Andrew Jacono as one of the 24 best plastic surgeons in America, citing his ability to achieve rejuvenation that “enhance[s]… natural balance” without an overdone look. He has authored over 50 peer-reviewed scientific articles in journals including Aesthetic Surgery Journal and JAMA Facial Plastic Surgery, and his 2021 textbook, The Art and Science of Extended Deep Plane Facelifting, serves as a technical reference for surgeons refining their approach to the methodology.

Dr. Andrew Jacono has served for most of his career as a Fellowship Director for the American Academy of Facial Plastic and Reconstructive Surgery, training Fellows in the advanced techniques central to his approach. That influence extends well beyond New York. London-based surgeon Dr. Gregor Bran stated in a recent Instagram reel that Dr. Jacono “is the reason everybody’s talking about Deep Plane facelift surgery” and that he “has taught everybody who is good everything he knows.”

The measure of a comprehensive approach is not how many procedures it includes. It is whether each component serves the patient’s specific anatomy and long-term goals. Treating the face in three dimensions, at each relevant tissue depth, means the results of surgery and skin treatment reinforce rather than contradict each other – which is ultimately what makes the difference between a result that looks like surgery and one that simply looks like time standing still.