The purveyor of what may be the world’s most expensive face-lift does not care one bit about what you or I or the keyboard warriors of social media have to say about it.

Recently, plastic surgeons have started disclosing their rates online, throwing back the curtain that has long shrouded their practice.

Dr. Andrew Jacono hasn’t joined the movement. “I don’t feel the need to constantly update people on what I’m charging,” says the New York–based surgeon. “I don’t have to justify my prices to anybody.”

His quote for an extended deep-plane face-lift—his spin on the classic deep-plane lift, first described in the 1990s—is $250,000. He stipulates, however, that this sum covers only the surgical fee for his face- and neck-lift procedure. It does not include anesthesia, the operating room, or recovery nurses and lodging. He also acknowledges that the majority of his patients need more than a standard face-lift, and the majority end up with a bill of well over $250,000. In most cases, he estimates, it’s more like half a million.

You Look Like a Million Bucks!

Jacono is somewhat of an anomaly in his field. He is a board-certified facial plastic and reconstructive surgeon who’s managed to elevate the role by blending substance with spectacle. He’s an easy target for critics, who have been known to roll their eyes at his prices and challenge the validity of the before-and-after photographs decorating his Instagram grid.

Nevertheless, he has built a vast and varied fan base that comprises not only adoring patients but also other plastic surgeons, who pack his lecture halls and operating theaters around the globe.

Jacono’s deep-plane procedure is reputed to be as thorough, durable, and undetectable as they come, due in part to his technique, which leaves the skin attached to the underlying muscle, allowing him to lift the two together to prevent a pulled appearance. By releasing key ligaments, he’s then able to effectively smooth the nasolabial folds from the nose to the corners of the mouth while raising fallen cheeks and heavy jowls.

“My outcomes are way above average,” he says, straddling the line between confidence and arrogance. “Colleagues fly in from all over the world to try to figure out how I create these outcomes. The truth is, it comes from a massive volume of experience and aesthetic judgment which, unfortunately, cannot be transmitted from person to person. At the end of the day, that’s what my patients are paying for.”

Jacono informs me, more than once, that he has performed over 4,000 face-lifts. He boasts of his “innate talent,” comparing himself to Michael Jordan on the court.

“Colleagues fly in from all over the world to try to figure out how I create these outcomes.”

Outside of academic circles, Jacono is best known for giving Marc Jacobs a face-lift in the summer of 2021. Jacobs posted a shot of himself the day after surgery, his head still wrapped in gauze with drains dangling by his earlobes, tagging Jacono and #f*ckgravity #livelovelift. (The viral post “was in no way solicited,” Jacono says. “There was no compensation—Marc paid for his surgery.”) While Jacono insists that Jacobs’s endorsement had little impact on his practice—”It didn’t change anything; I’ve been busy like this forever”—it swiftly piqued public interest.

The demand for plastic surgery is soaring. According to a new survey from the American Academy of Facial Plastic and Reconstructive Surgery, nearly 60 percent of its members saw an increase in procedures over the past year, with many seeing significant increases in business. And Jacono may be chief among the busiest. “We’re scheduling a year and a half to two years ahead—and that’s a problem,” he says. “I take care of a lot of actors and models. I take care of a lot of royalty. I take care of people who don’t have the time [to wait]. In order to stem the tide—to reduce the number of patients who are in line to have their surgical treatments with me—I continually increase my prices.”

Fair warning: he’s planning another price hike in the coming year.

“It’s off-putting to some, but I’m not for everybody,” he adds. By his own calculation, he is, in fact, for only the .01 percent. “It’s not uncommon for me to have a patient fly their private jet from another country, land for a consultation, and then turn around and go back home on their private jet,” he says. “That is not an occasional thing; that is a routine thing. My patients are not 1 percenters, because a 1 percenter would not spend $500,000 on a total facial rejuvenation.”

If all those zeros don’t give you pause, the notion of total facial rejuvenation might. As Jacono explains, the traditional face-lift does not actually lift the face in its entirety. It retools only the lower half of the face, along with the neck.

The surgery is limited, by definition. It doesn’t touch the sagging brows or eyelids or the strip of skin between our nose and mouth that elongates over time. But not to worry! Each area can be addressed during the procedure—via a brow lift, an eye lift, and a lip lift—for an additional charge. And don’t forget the finishing touches. Without an infusion of volume, a lifted face risks resembling a windsock in a summer storm: taut but hollow. That’s where the fat transfer comes in. Jacono liposuctions fat, usually from the abdomen or hips, purifies it, and then injects it into the face at the temples, around the eyes and mouth, and in the hollows of the cheeks. Then he blasts away hyper-pigmentation and fine lines with a CO₂ laser. Add it to the tab!

“In order to create results that look seamless, you need to treat all areas,” Jacono explains. “It’s really no different than tailoring clothing.” You wouldn’t manipulate the shoulder of a blazer without subsequently tweaking the sleeve. “It wouldn’t look right; you’d see areas of transition,” he notes. “A pleat by the corner of the eye, a fold in the wrong place—these things draw attention,” like neon signs flashing, NIPPED & TUCKED. “My patients don’t look like they’ve been operated upon; that’s the signature of my work,” he says.

The process is every bit as painstaking as it sounds. Thus, Jacono performs only one or two face-lifts a day. Further compressing his calendar, he operates just three days a week, reserving Mondays and Fridays for personal pursuits. (He’s opening Bibliotheque, a bookstore/wine bar with his son, A.J., in SoHo, later this year.) Jacono travels with his family, often to Italy, for roughly a third of the year.

If you simply cannot wait to receive his scalpel, there are ways to jump the line. For V.I.P.’s with important events on the calendar, the doctor may be willing to relinquish a day off (though he tries “not to make a habit of it”). Alternatively, his staff quietly keeps a cancellation list. Every month, he says, there are a handful of patients with last-minute conflicts who must surrender their precious spot on his schedule. You might consider liquidating some assets in anticipation.

Jolene Edgar is a writer who frequently contributes to Town & Country, Allure, and Harper’s Bazaar