Dr. Andrew Jacono’s “Ponytail-Friendly” Facelift Incisions

Scars have long been one of the telltale signs of a facelift. Dr. Andrew Jacono designed his signature procedure with that problem in mind. The Minimal Access Deep-Plane Extended (MADE) facelift uses incisions roughly one-third the length of those in conventional techniques.

Those shorter incisions are placed behind the ear and along the hairline. Patients can wear their hair pulled back without exposing visible scarring, which is why the New York surgeon describes the procedure as “ponytail-friendly.”

Smaller Openings, Deeper Work

The minimal access design does not mean a shallow operation. The facelift goes beneath the superficial musculoaponeurotic system, or SMAS, the layer that conventional surgery leaves largely in place. Standard facelifts lift skin off the SMAS and pull it taut, an approach that can look stretched and generally lasts six to eight years.

Dr. Andrew Jacono’s technique keeps skin, muscle, and fat joined as a unit. He frees four ligaments that tie facial tissue to bone, which lets him reposition descended fat pads in the midface, jawline, and neck on a vertical vector. The method targets volume loss and tissue descent, two core reasons faces look older.

Published Outcomes

The technique first appeared in Aesthetic Surgery Journal in 2011, where Jacono documented results in 153 patients. Initial data recorded a 3.9% revision rate, roughly 1.9% hematoma, and 1.3% temporary facial nerve injury. Those rates sit below industry averages. Later studies found that deep-plane techniques carry a lower chance of facial nerve injury than superficial methods, because the dissection preserves anatomical relationships and blood supply. Results can last about twice as long as a standard SMAS facelift, with many patients keeping them more than ten years.

Today Dr. Andrew Jacono performs approximately 250 extended deep-plane facelifts annually in Manhattan. The dual board-certified surgeon has lectured at over 100 international conferences. His 2021 medical textbook drew on more than 2,000 facelift procedures, and other surgeons now follow the standards it set. Refer to this article to learn more.

See for more information about Dr. Andrew Jacono on https://www.instagram.com/drjacono/?hl=en