Aesthetic Surgery

Aesthetic Surgery - Facelift Surgery Following Superficial Parotidectomy: Is it Safe?

Patients who have previously undergone superficial parotidectomy may later seek facelift surgery for facial aging and rejuvenation. They present challenges quite different from the standard facelift patient; for example, the location of facial nerve branches is superficial and displaced compared to standard anatomy. In addition, significant contour deformities may be present.¹⁻⁴ The Dermatology and Plastic Surgery Institute conducted a retrospective review from 2000–2017 of 11 patients to assess potential morbidity and safety of facelift surgery in parotidectomy patients.

Evaluation included pre- and postoperative facial nerve status, soft tissue contour and scar deformities, facelift technique, ancillary soft tissue augmentation procedures, and pre- and postoperative photographs.

Seven of 11 patients underwent facelift surgery as a secondary procedure, while 4 patients underwent a simultaneous facelift at the time of removal of the superficial parotid tumor. Soft tissue augmentation was performed in 1 patient. Nine patients (82%) received nerve integrity monitoring (NIM) stimulation. No postoperative facial nerve injuries were noted.

Facelift following superficial parotidectomy was safely performed in all cases. Soft tissue augmentation procedures were needed in the minority of patients and scar tissue presented no additional technical challenge. These patients should be considered candidates for aesthetic surgery.

Demographics and Patient Characteristics (N = 11)

2000 - 2017

Demographics and Patient Characteristics Results
Average patient age 65.5 (51 – 76)
Coronary artery disease 36.4%
Current tobacco users 18.2%
Former tobacco users 36.4%
Patients with concurrent facelift and parotidectomy 36%
Patients with subsequent facelift after parotidectomy 64%
Postoperative Parotid Pathology Results (N = 11)

2000 - 2017

Parotid Pathology Results
Percent
Parotid pathology: benign pleomorphic adenoma 63.7
Parotid pathology: benign adenoma 27.3
Parotid pathology: undocumented 9
Preoperative photo
Postoperative photo
Postoperative photo
Postoperative photo 9 months following the facelift procedure
References

1. Jost G, Guenon P, Gentil S. Parotidectomy: a plastic approach. Aesthetic Plast Surg. 1999;23(1):1-4.

2. Barrett BM, Rose FA. Aesthetic cervicofacial surgery for head and neck tumor patients. Aesthetic Plast Surg. 1984;8:123-128.

3. Boynton JF, Cohen BE, Barrera A. Rhytidectomy and parotidectomy combined in the same patient. Aesthetic Plast Surg. 2006;30:125-131.

4. Baj A, Beltramini G, Demarchi,M, Combi V, Gianni,A. Bilateral SMAS rhytidectomy in parotid recurrent pleomorphic adenoma. ACTA Otorhinolaryngol Ital. 2011;31(4):256-258.