Use of the SMAS Flap in Benign Parotid Gland Surgery: Review and 5 Years Experience

Superficial parotidectomy is considered the gold standard for the treatment of the benign lesions of the parotid gland. However, the procedure is burdened by various complications such as sialocele, facial palsy, salivary fistula, and Frey's syndrome. The SMAS flap is widely used in plastic surgery for the face-lifting procedure. This surgical technique allows to obtain, in comparison with the traditional technique, a better redistribution of the tension forces during the traction of the skin. Rarely the SMAS flap is used for the surgical approach to the parotid gland which is, generally, directly approached.

After a brief description of the SMAS anatomy and a short review of the SMAS flap procedure, we propose our experience about the use of the SMAS flap in the parotid gland surgery. We describe the details of the technical procedure through an explicative clinical case of a 73-year-old woman with pleomorphic adenoma of the left parotid gland. The description is attended by the images of all the surgical phases.

The procedure we propose presents a lower risk of complications and better aesthetic outcomes in comparison to the traditional approach to the parotid gland.