As the man behind the lifted looks of luminaries like Marc Jacobs, facial plastic surgeon Dr. Andrew Jacono is on the cutting edge of how to look and feel our best. We checked in with the Southampton resident for the latest on everything from face-lifts to filler fatigue and why patients are suddenly living their truths when it comes to sharing their journeys.
“There’s a newfound transparency in this post-COVID world,” offers Dr. Andrew Jacono when we check in as the buzz around Marc Jacobs’ well-documented face-lift journey is setting the internet on fire. “People seem to be living their truths about everything—their jobs, their relationships, their friends and even their beauty routines. People are making bold changes in their lives as they lean into what truly makes them happy. More than ever, people are opening up about these changes—they’re broadcasting them like badges of courage, and their audiences are responding with applause for their honesty. This ‘truth journey’ trend can also be seen in cosmetic surgery,” he shares. “Those that have wanted to have surgery are finally doing it, and just like sharing their new outfits on social media, they’re now sharing their new faces with pride. There’s no shame in using the tools available to you to look and feel your best, and people are realizing this. Marc Jacobs is a pioneer of many things, so of course him sharing his face-lift journey fit with his honest and transparent nature—I found it to be very admirable.”
Admirable, indeed. For those of you not yet a follower of Dr. Jacono, we highly recommend you add @ drjacono to your must-follow list for jaw-dropping (er, shall we say jaw-defining rather) before and afters that would make even the barely Botox-ed set book their lift for years to come. His feed is full of natural-looking results that spotlight the patient’s inherent beauty rather than scream “I had work done.” So when fashion royal Marc Jacobs decided to go under the knife, it was no surprise he went with Jacono.
“Marc was a good candidate for surgery because he had exhausted many other options under the care of a skilled and measured cosmetic dermatologist,” he explains. “He had been through his injectable filler journey, which had kept him looking good for many years. He also had multiple treatments with Ultherapy and thread lifts, but eventually as he aged they became less effective. There comes a time when the tissue is just too lax and surgery is needed—he had gotten to this point in his journey.”
And why does Jacono think plastic surgery has been folded into the beauty toolkit in recent years? After all, it’s more involved than, say, getting highlights or Botox. “As techniques advance, results appear more natural, and as people become more open to sharing their journeys, the acceptability grows. Cosmetic procedures are just another tool in the toolkit of looking and feeling your best, and just as you might share your favorite colorist with your friends, people are increasingly sharing their favorite cosmetic doctors as well.” He notes a 30% rise in men seeking face-lifts, attributed to increased pressures brought on by the Zoom boom and general social media microscope. “Many men speak of this increased pressure in terms of their need to look youthful to stay competitive in the workforce,” he says. “Also, today’s advanced, minimally invasive techniques, along with hyperbaric oxygen therapy for rapid healing, can get a patient back to their daily routine in 10 days on average, so surgical procedures, including face-lifts, have generally become more accessible to those with highly demanding schedules.”
Something else driving the uptick in face-lift demand is a phenomenon called “filler fatigue,” which can literally be seen on the faces of guests dining at any restaurant out East and is attributed to an overfilled face, not a bad face-lift. “Anything that you put in your face is occupying a space that wasn’t there, and because of this you’re always stretching the tissues to some degree,” he says. “When a skilled cosmetic dermatologist uses small amounts of filler in the right places, the results can be positive, but it’s when the face is overfilled, and unfortunately this can be seen almost everywhere we look, that the skin can be materially stretched. As people continue to age and volume continues to decrease, the amount of filler used increases to compensate for volume loss, but there comes a point when fillers are not producing the same results as they used to. The tight skin that used to perk up when filler was introduced is now lax and sags when the added weight of filler is introduced, resulting in a distorted, overfilled look.” Jacono advises working with a well-credentialed cosmetic dermatologist to guide you on your aging journey and help you decide when it may be time for surgery.
While face-lifts might have seemed daunting in the past, the thing that celebrities have known for a while and that we are just discovering is that the new face-lift doesn’t look like a face-lift at all. “The ‘traditional’ face-lift approach called a SMAS face-lift can create an unnatural stretched appearance to the face, and since the SMAS muscle is tightened toward the ears, it often distorts the corners of the mouth. My M.A.D.E. (Minimal Access Deep Plane Extended) deep-plane face-lift technique lifts the skin and muscle (SMAS) together as one unit and repositions all deep cheek fat pads and musculature. Since the skin is not separated from the deep structure, the lift comes from under the deep structure, so the surface appears smooth, not tight. This also helps maintain the blood supply to the face, allowing for more rapid healing. Key facial ligaments that support the face are lifted, rebuilding the beams of the face, creating a longerlasting result. Another tenet of the deepplane face-lift is the drooping tissues are lifted vertically against gravity, re-creating the heart-shaped face of youth. I use minimal access incisions that are shorter and hidden, made possible by endoscopic technology. My female patients are able to wear their hair back in ponytails, and my male patients are free to wear short haircuts or shave their heads because of hair loss. It is a technically more complex procedure, but the results are more rejuvenating and longer-lasting, approximately 10 to 12 years versus a traditional face-lift, and the procedure is usually performed under twilight anesthesia.”
With many of us suddenly taking a “carpe diem” approach to life about seemingly everything, this Marc Jacobs honesty moment has many faces from Montauk to Paris wondering if now is their time to step out from behind the curtain and get the nip, the tuck, the facelift they’ve long been pondering.
Photography by: PHOTO BY ZULMAURY SAAVEDRA/UNSPLASH