[Aesthetic parotidectomy: face lift incision and SMAS flap].
BACKGROUND
Traditional parotidectomy skin incision (bayonet-shaped incision) is adapted from an extirpative standpoint but not ideal cosmetically. There are three main drawbacks: Scar, retro-mandibular depression and Frey syndrome. The goal of this prospective study was to evaluate the feasibility of this facial incision for extirpative purposes and to define the clinical benefit in terms of scar and retromandibular depression.


METHODS
Ten patients with parotid tumors were included during the period 2005-2006. All patients had benign tumours: 5 males and 5 females. Mean age was 49 yrs. (42-67). Investigated parameters were: "retromandibular depression", "skin scar" and "Frey syndrome". Analogic visual satisfaction scale (1-10) was used by patients to assess these data postoperatively at 15 days, 1 month and 6 months.


RESULTS
This face lift approach allowed very good surgical exposure not only of the parotid area but the posterior submandibular region and over the sternocleidomastoid muscle. Postoperative lateral facial contour was symmetric and good in all cases. Six patients assessed this parameter 8/10 and 4 assessed 10/10. After removal of stitches the facial skin scar was considered good in 100% of cases. Six patients assed this parameter 9/10 and 4 assessed 10/10. No Frey syndrome was reported by any patients within 16 months postoperatively.


CONCLUSIONS
Association of a face skin lift approach and a SMAS flap yields a very good cosmetic outcome after surgical parotidectomy. As aesthetic considerations are obvious in breast surgery, aesthetic considerations have a great place in parotid and head and neck surgery.
Paris
J
J
Institut Clairval de Chirurgie ORL et de la Face, Centre Hospitalier Privé Clairval, 317 Bd du Redon, 13009 Marseille, France. j.paris@iccorl.fr
Richard
O
O
Lafont
B
B
Facon
F
F
Bruzzo
M
M
D000328:Adult; D000368:Aged; D002921:Cicatrix / Q000517:prevention & control; D004954:Esthetics; D005145:Face / Q000033:anatomy & histology; D005205:Fascia / Q000637:transplantation; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D010306:Parotid Gland / Q000601:surgery*; D010307:Parotid Neoplasms / Q000601:surgery; D017060:Patient Satisfaction; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D015361:Rhytidoplasty / Q000379:methods; D012867:Skin / Q000473:pathology; D013524:Surgical Flaps; D013547:Sweating, Gustatory / Q000517:prevention & control