The typical facelift patient used to wait until their sixties to address sagging jowls and neck laxity. That timeline has shifted dramatically. Dr. Andrew Jacono, a Manhattan-based facial plastic surgeon, reports that the average age of his facelift patients now sits in the mid-40s. The change reflects a broader cultural shift where people view surgical intervention as preventive maintenance rather than emergency repair.
Town & Country profiled Dr. Andrew Jacono’s observation that people now aim to maintain a youthful appearance earlier rather than wait for visible aging to become pronounced. The shift connects to career longevity, remote work visibility, and a generation that expects to work productively into their seventies.
Men Enter the Conversation
Male patients represent the most striking demographic change. Dr. Andrew Jacono notes that men now account for 20% of his facelift cases, up from just 2% a decade ago. Professional competition drives much of this demand. Men competing for executive positions or client-facing roles recognize that appearing fatigued or older than colleagues creates disadvantage in business environments.
The extended deep-plane facelift technique Dr. Andrew Jacono pioneered addresses this demographic’s concerns about discretion. Incisions hidden behind the ear and along the hairline remain invisible even with short hairstyles. Results last 12 to 15 years when key factors align, including technique, lifestyle, skin quality, and care. That longevity matters for professionals who want one intervention rather than repeated procedures throughout their careers.
Even plastic surgeons choose Dr. Andrew Jacono for their own procedures. Dr. Paul Nassif, known from the reality show Botched, traveled from Beverly Hills to New York for his deep-plane facelift. Fashion designer Marc Jacobs went public in 2021 about his choice of Dr. Andrew Jacono, helping normalize surgical intervention among men in creative industries.
Prevention Over Correction
The earlier intervention trend stems from understanding how faces age. Waiting until tissue has descended dramatically requires more extensive surgery. Addressing early changes—mild jowling, initial midface deflation—allows less invasive approaches with faster recovery.
Dr. Andrew Jacono’s extended deep-plane technique operates beneath the superficial musculoaponeurotic system (SMAS), repositioning descended fat pads and releasing weakened ligaments. Town & Country described how “Jacono keeps the skin, muscle, and fat as one unit” rather than pulling surface tissue taut. The approach produces natural results that avoid the “done” appearance that characterized older facelift techniques.
Patients in their mid-40s typically show early structural changes without severe sagging. Surgery at this stage requires less tissue manipulation and produces subtler enhancement. The preventive model parallels how people now approach fitness and nutrition—consistent maintenance rather than crash interventions.
Economic Calculations Drive Timing
The longevity economy extends working lives into people’s seventies and eighties. Someone undergoing a facelift at 45 with results lasting 12 to 15 years maintains professional appearance through peak earning years. Delaying surgery until 60 might require revision procedures before retirement age.
Dr. Andrew Jacono performs approximately 250 deep-plane facelifts annually at his Manhattan practice. Volume allows continuous technique refinement, which contributed to Newsweek ranking him as the third-best facelift surgeon in America for 2025. He has served for most of his career as a Fellowship Director for the American Academy of Facial Plastic and Reconstructive Surgery, training the next generation of specialists in advanced techniques.
His 2021 medical textbook, The Art and Science of Extended Deep Plane Facelifting, synthesizes insights from over 2,000 procedures. The publication serves as a technical guide for surgeons seeking natural results that justify earlier intervention timing.
Recovery Considerations for Working Professionals
Younger patients often have tighter schedules and less flexibility for extended recovery. Dr. Andrew Jacono’s technique reduces downtime compared to traditional facelifts. Keeping tissue layers together rather than separating skin from muscle preserves blood supply and speeds healing.
The “ponytail-friendly” incision placement allows people to return to work without obvious signs of surgery. Social bruising typically resolves within two weeks, and most patients resume professional activities within that timeframe. The reduced recovery period makes early intervention practical for people managing careers and family responsibilities.
Remote work platforms that display high-definition video close-ups have accelerated demand for facial procedures. People seeing themselves on screen during meetings notice aging signs they might have overlooked in bathroom mirrors. The constant visual feedback creates awareness of how others perceive their appearance in professional contexts.
Dr. Andrew Jacono also maintains academic appointments as Associate Clinical Professor at Albert Einstein College of Medicine and Section Head of Facial Plastic and Reconstructive Surgery at North Shore University Hospital. He has published more than 70 peer-reviewed articles documenting outcomes and refining surgical approaches.
The shift toward earlier surgical intervention reflects practical calculation rather than vanity. People investing in career longevity view facial rejuvenation as professional maintenance, similar to updating skills or maintaining fitness. Dr. Andrew Jacono’s practice demonstrates how surgical technique has evolved to meet this demographic change, producing natural results that support extended working lives without obvious signs of intervention.