For years celebrities have denied the patent handiwork of aesthetic doctors, preferring to wax lyrical about the rejuvenating effects of yoga and juice cleanses. It is an established protocol that reinforces magical thinking among non-celebrities and cements an unnecessary taboo about plastic surgery.
So, it was with pleasant surprise that we double tapped on an Instagram post from Marc Jacobs earlier this year. The fashion designer, now 58, defied the unwritten rules of fame and publicly shared an imaged of his face swathed in distinctly un-designer bandages. The caption name-checked lauded New York surgeon Dr. Andrew Jacono and used the tactful hashtag #f*ckgravity.
Jacobs had just undergone a deep-plane facelift, which is thoroughly different from the run-of-the-mill nip-and-tuck job. It is the Franck Muller of facelifts: wildly expensive, hard to find, intelligently designed and, crucially, capable of weathering the years without falling apart. It is a major piece of surgery but, in the right hands, yields surprisingly natural-looking results with minimal downtime.
In stark contrast to the wind-tunnel facelifts of yesteryear, the deep-plane technique doesn’t depend on pulling skin or muscles tight in an effort to defy gravity. Instead, the surgeon focuses on the supportive structures of the mid-face, below the skin and superficial muscular aponeurotic system, or SMAS.
In what sounds like the premise for 1997’s Face/Off, both the skin and the fibromuscular sheet beneath it are detached as a single unit. This means that no tension is placed on the skin, affording the patient plausible results and a whole world of potential facial expressions.
Instead of a standard facelift’s cut-and-pull technique, the surgeon releases four key ligament groups around the cheeks and jaw, and moves everything upward rather than backward. This vertical reorientation automatically eliminates jowls and allows the cheek pads and muscles to sit higher on the face, giving a naturally youthful—as opposed to wildly altered—appearance (fat pads have an alarming habit of slipping down the face with age). An added bonus of targeting the mid-face in this fashion is that nasolabial folds (the lines that run from nose to outer chin) are ironed out in the process, too. Put simply: The lifting effect is voluminous and vertical rather than tight and horizontal.
Since the skin has no tension placed on it, the edges where incisions have been made can heal easily and with little scarring. Different doctors employ different incision techniques but, in many cases, scars are minimal and barely invisible. To prove this point, Dr. Jacono has posted numerous case studies on Instagram, in which there are no telltale marks, even in men with short haircuts. For all these reasons, the deep plane has become the gold standard in facelifts.
There is, of course, a catch: only five percent of plastic surgeons are equipped to do such technical work, and that is reflected in the price tag. A deep-plane facelift can cost anywhere between $25,000 and $50,000 depending on where you go, and any extras (like eye-lifts or fat removal) that you throw into the mix.
It is unsurprising, then, that the deep plane has become popular with Hollywood’s elite and C-suite executives—people with both the resources and access to the best doctors. Whether they’ll all be quite as candid as Jacobs is a matter of personal choice.