Optimizing the Aesthetic Result of Parotidectomy with a Facelift Incision and Temporoparietal Fascia Flap

The 3 most common problems after a parotidectomy are cheek contour deformity, Frey syndrome (gustatory sweating), and a visible scar on the neck. These problems can potentially be prevented by (1) facelift type incisions, which eliminate the neck incision and (2) interposition of temporoparietal fascia at the parotidectomy site that fills the defect and provides a barrier to aberrant neuronal regeneration. We followed 11 patients who underwent parotidectomy (9 superficial and 2 total parotidectomies) for a variety of parotid tumors between December 2001 and January 2018. Facelift type incisions were used in all patients, and temporoparietal fascia flaps were used to fill the parotidectomy defects. The last 6 patients were tested for objective evidence of Frey syndrome with the Minor Starch Iodine test. Patients were then followed for up to 7 years (11 months to 7 years, average 3 years). All patients had well-hidden scars and good contour of the cheeks. None of the patients developed subjective or objective evidence of Frey syndrome. This small series suggests that the aesthetic result after parotidectomy can be improved by using a facelift incision and placement of a temporoparietal fascia flap into the parotidectomy defect. Additionally, the tissue barrier thus provided may also help to prevent Frey syndrome.