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Facelift Surgery Following Superficial Parotidectomy: Is it Safe?
Christopher Surek, DO, Andi Cummins, Isis Scomacao, MD, Eliana Duraes, MD, James E. Zins, MD
Cleveland Clinic
2018-02-15
Presenter: Andi Cummins
Affidavit:
I certify the project represents original work of the residents and authors on this project.
Director Name: Steven Bernard, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Aesthetics
Introduction: 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. Most concerning is the location of facial nerve branches, which will be superficial and displaced compared to standard anatomy. In addition, significant contour deformities may be present. Our series of such patients is reviewed in order to document potential morbidity and safety of facelift surgery in parotidectomy patients.
Methods: In this retrospective case series, 11 patients who underwent facelift surgery following superficial parotidectomy, or at the same time as parotidectomy, from 2000-2017, were reviewed. 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.
Results: 7 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 one of 11 patients. Precautions to identify the facial nerve and prevent injury including NIM stimulation were documented in 9 (81%) of patients. No postoperative facial nerve injuries were noted.
Conclusion: 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. Therefore, these patients should be considered as candidates for aesthetic surgery and should not be denied out of hand.
