Forget Botox, full-on facelifts are hotter than ever


When Marc Jacobs decided to get his first-ever facelift earlier this year, he opted for a plastic surgeon known for delivering astonishing, yet somehow utterly believable, results: New York City-based Andrew Jacono

Between Jacono’s signature MADE (Minimal Access Deep Plane Extended) facelift technique and the use of hyperbaric oxygen therapy for rapid healing, the 58-year-old designer not only emerged as fresh as a daisy, he also got major “transparency” cred for documenting virtually the entire process on Instagram. There he was, mummified in bandages, directly post-op. Next up were blissed-out shots from the oxygen chamber and lots of #livelovelift and #f*ckgravity hashtagging.

“I was honored that Marc chose me to do his facelift,” says Jacono, who estimates that a hefty 30 percent chunk of his clientele is male. “He was a good candidate because he had exhausted many other options under the care of a skilled and measured cosmetic dermatologist.” 

In other words, at a certain point, all the Botox and filler in the world just aren’t going to cut it. In fact, too much of the latter — i.e., years of Juvéderm, Restylane or Sculptra injections — can result in “filler face,” or unsightly stretching.

“Anything that you put in your face is occupying a space that wasn’t there,” says Jacono. “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 everywhere we look — that the skin can be materially stretched.”

It certainly isn’t just high-profile New Yorkers like Jacobs (and fellow Jacono patient Sonja Morgan, of “RHONY” fame) who are moving on from stop-gap dermatological procedures and carving time out of their schedules for a surgical refresh. According to the most recent statistics released by the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), COVID-driven “Zoom dysmorphia” has created an unprecedented demand for surgery across the US, driving the first decline in noninvasive treatments in nine years. According to a recent AAFPRS member poll, facelifts were up 69 percent in 2020 versus 2019.

Marc Jacobs at a fashion show in New York City.
Saving face: Marc Jacobs (above) sought the services of NYC-based Dr. Andrew Jacono.
Gotham/GC Images

Classic cutting is back in, like the limited incision/short scar facelift technique pioneered by New York City-based plastic surgeon Gerald Imber decades ago, along with his newer “C-lift” for men, which features a C-shaped incision in the upper sideburn that allows him to tighten facial muscles and cheek skin with no visible scar. Although he already had more than 3,000 facelifts under his belt, Imber says this past spring and summer have been the busiest time of his entire career. “Apparently no one got younger or better looking through the COVID horror,” he quips. “The call to action sounded as soon as we began to see one another.”

“My answer to the question, ‘Is it time, or am I too young?’ is always the same: This is about the mirror, not the calendar.” 

Plastic surgeon Gerald Imber

Like Jacono’s recommendation for post-op oxygen, which can get patients out and about in as few as 10 days, Imber now routinely augments his lifts with fat transfers to the cheek area for a bit more volume. An alternative to fillers, the minimally invasive procedure “uses your own fat, and most of us have plenty to donate. A good percentage of the result is permanent, and it always looks natural, because it is natural.” 

Other add-ons Imber suggests for amping surgery results? Deep microneedling and platelet-rich plasma injections to improve skin quality and boost collagen production, and earlobe shortening for an overall friskier, more youthful effect. “I’m doing lots of earlobe shortening,” he notes. “It sounds funny, but the three things that make people look aged are loss of facial volume, stretching of the earlobes and drooping of the nasal tip.”

Call it the Facelift Plus — the core procedure with extra tweaks that either reduce the lengthy downtime typically associated with plastic surgery, or help the results last longer. Rather than a dramatic overhaul, and an overly taut, stretched look that screams “bad work,” patients who align themselves with skilled surgeons can expect a more realistic rejuvenation that Jacono says can hold up for a decade-plus. 

Given how young first-time facelift patients are these days (40 is the new 60 in surgical suites), coupled with how long we’re living, the longer a facelift lasts, the better. 

While the American Society of Plastic Surgeons says the average cost of a facelift in the US was $8,005 in 2020, a New York-caliber “facelift plus” will set you back considerably more. While Imber’s approximate starting price for a facelift with cheek-fat transfer and skin resurfacing is $33,750, Jacono fetches at least $80,000 for his signature extended deep plane facelift alone (when he’s not busy saving fellow airline passengers). Bundle that with a neck lift, fat grafting and fractional CO2 laser, and Jacono’s bill swells to $160,000. And that doesn’t include the $400 hyperbaric oxygen therapy sessions, which take place off-site. 

But for anyone who wants to get ahead of aging, there’s no shame in the surgery game.

“My answer to the question, ‘Is it time, or am I too young?’ is always the same,” says Imber. “This is about the mirror, not the calendar.” 

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