By Dr. Gina Maccarone, MD, FACS, FAACS

In cosmetic surgery, one of the most exciting parts of my journey is the ability to keep learning, growing, and refining the care I provide to my patients. The techniques we use today are not the same ones surgeons relied on even ten years ago. As our understanding of anatomy, healing, and artistry evolves, so do the results we’re able to achieve. That’s why professional growth and education will always be at the heart of my practice. I want my patients to benefit from the safest, most advanced, and most natural-looking techniques available.
One of the newest procedures I’ve added to my practice is the “Preservation” Deep Plane Facelift, a technique pioneered and refined by Dr. Mike Nayak and his colleagues. Dr. Nayak is not only a leader in this field but also a mentor to me, and I’ve had the privilege of training with him to learn the nuances of this advanced approach. His influence and expertise have been invaluable in shaping how I bring this technique into my own practice, ensuring that my patients receive the same meticulous, state-of-the-art care.
So, what makes this approach different? Traditional facelifts, and even SMAS (superficial muscular aponeurotic system) lifts, focus on tightening the skin and only partially adjusting the layer beneath it. While these can create improvement, they sometimes lead to that “pulled” or overly tight look that patients fear. The deep plane extended facelift works slightly deeper, completely releasing and repositioning the muscle and fat layers (SMAS) while leaving these layers attached to the skin in most areas of the face. This allows the cheeks, jawline, and midface to be positioned in a way that looks effortless and never stretched. It restores facial shapes passively, the way they existed in youth, rather than forcing tissues into place.
The “preservation” aspect of Dr. Nayak’s technique is equally groundbreaking. Because the dissection is performed almost entirely in the deep plane, well below the delicate layer under the skin, it dramatically reduces trauma to blood vessels. That means a lower risk of hematoma (a potential bleeding complication), smoother skin, and healthier recovery. It’s an incredibly meticulous surgery, but the outcomes are striking: youthful contours, natural volume restoration in the cheeks, softened nasolabial folds, and a crisp, defined jawline.
This approach also extends its benefits to the neck, which is so often a giveaway of age. By combining the extended deep plane facelift with a deep neck lift, we can address banding, fullness, and sagging skin in one procedure. The result is harmony from the midface down through the jawline and neck, a seamless, rejuvenated look that doesn’t call attention to the fact that surgery was ever performed.
What excites me most is that these results last. Many patients enjoy their rejuvenation for 10 to 15 years, sometimes longer, depending on their lifestyle and self-care. Unlike filler or surface treatments that provide temporary improvements, a deep plane facelift is structural. It repositions tissues to where they naturally belong.
Of course, it’s important to acknowledge that this procedure is technically demanding. Not all surgeons perform it, and it requires advanced training and deep knowledge of facial anatomy. For me, that challenge is what fuels my passion. I’ve built my career on precision, artistry, and compassion, and I see this facelift technique as the next step in offering my patients the most elegant, lasting results possible.
Every investment I make in continuing education, whether that’s training under mentors like Dr. Nayak, attending surgical conferences, or incorporating the latest techniques into my practice, is ultimately an investment in my patients. You deserve a surgeon who isn’t just skilled, but who is constantly striving to bring you the very best of what modern cosmetic surgery has to offer.
If you’ve been considering a facelift but worry about looking “different” or “done,” know that there are techniques designed to avoid exactly that. With the “Preservation” Deep Plane Facelift, the goal isn’t to change who you are. It’s to restore balance, refresh your natural features, and help you feel confident and comfortable in your own skin.
Xo,
Dr. G