Every face has anchor points, ligaments that tether skin and soft tissue to the underlying bone. As these ligaments loosen with age, fat pads in the cheeks and jawline slide downward. Dr. Andrew Jacono built his signature facelift technique around releasing four of these key ligaments.

Standard facelifts tend to leave these attachments untouched, focusing instead on trimming and pulling the skin above them. That approach can smooth surface wrinkles temporarily, but it does not address why the face sagged in the first place.

Freeing the Deep Structure

The Minimal Access Deep-Plane Extended technique, or MADE, releases those anchor points so tissue can move vertically rather than simply backward. This vertical repositioning restores volume to areas that have lost it, particularly across the midface, along the jawline and through the neck.

Because skin, muscle and fat move together instead of being separated, the lift comes from deeper structural support rather than surface tension. A quote from Town & Country captured the distinction well, noting that Dr. Andrew Jacono keeps the skin, muscle and fat as one unit during the procedure.

Built on Published Research

Dr. Andrew Jacono introduced this approach in the early 2000s and later documented his results formally, publishing his findings in the Aesthetic Surgery Journal in 2011 with data from 153 patients. That publication gave surgeons outside his own practice a reference point for the technique’s outcomes.

Patients considering facial rejuvenation are increasingly told that skin laxity is part of the story rather than the whole story. Volume loss and downward tissue migration play an equally large role, which is why an approach built around ligament release, rather than skin tension alone, has drawn attention from surgeons and patients researching longer-lasting options.

Ligament release is a delicate part of any deep-plane procedure, since these connective bands sit close to nerves that control facial movement. Surgeons who specialize in this area typically emphasize training and repetition as the difference between a technique that reads well in theory and one that performs consistently across hundreds of real patients with varying anatomy.

For anyone comparing consultations, asking a surgeon directly how ligament release factors into their specific approach a useful way can be to separate deep-plane marketing language from an actual structural methodology. Refer to this article for additional information.

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