I had a full facelift. Afterwards the parotid gland on left side began leaking & I was swollen. Will it go away? (Photo)

Question

Drain in put in and took Zyrtec D, but it continued to leak. Pressure used and Botox flow stopped, but now if i don't have pressure on it, I get a swelling in that area He told me this swelling is scar tissue forming on the gland. Will this go away? I also have Bells Palsy from surgery or maybe the swollen parotid. (I did have Bells 38 years ago when i was pregnant. I had about 95% recovery, I still had some drooping of the eyelid and corner of my mouth which was the reason I wanted a facelift.)

Larry S. Nichter, MD, MS, FACS · Answer

First it would be important diagnose whether you have a seroma or a parotid fluid collection. To tell the difference between parotid gland secretions and a seroma  have the fluid analyzed by doing  an amylase test. Amylase is an enzyme found in saliva  produced by the parotid gland. In addition to the Zyrtec, a Scopolamine  Patch, Botox, and staying away from spicy and sour foods are often effective  to resolve fluid collection from the parotid gland (sialocele/fistula) originating from the parotid gland.Although it takes a while, for the VAST majority it will resolve.

Kevin Sadati, DO · Answer

I have performed several thousand face ifts and I have hadtwo situation similar to yours, my patients did well after 3 weeks. Thetreatment of choice was a conservative one.Pressure dressing, drain in place, avoidance of spicy and sour diets, aswell as anti-cholinergic medications are proper treatments for leaking parotidgland. Be patience and hang in there, you’ll get better. Good luck and goodhealing.

James M. Ridgway, MD, FACS · Answer

The question you ask is a very good one. It is not common
for patients to have a facial nerve injury after a facelift procedure, nor is
it common for a patient to have reduction of the salivary glands (parotid or
submandibular). However, in some circumstances it makes all of the difference
in the overall facelift result. To ensure your recovery is complete it is
important to follow your surgeon’s instructions regarding post-surgical care.
Patients who have surgery or injury to the parotid gland have notable swelling.
With the leaking that you mentioned it does sound like the pressure dressing
and Botox helped to stop the development of a fistula, but the Botox can also
weaken the facial nerve. You do not haveBell’s Palsy, but it is hard to offer greater details with the limited
information provided. Hopefully
this is helpful to you. Be healthy and be well, James M. Ridgway, MD, FACS

Emmanuel Mallol Cotes, MD · Answer

Thanks for sharing your concerns with us. Palsy after facelift can be transitory I recommend you to follow your surgeon advices!hope you get well soon. Dr. Emmanuel Mallol Cotes.-

Don W. Griffin, MD · Answer

Parotid gland leaks almost always seal up on their own with drainage and medications. It can take several weeks to months to completely stop leaking. You mentioned that you received botox injections to your parotid. If your Bell's Palsy symptoms started after the injections or worsened after the injections, this should resolve as your botox wears off. Facial nerve injuries can take three to six months to resolve if it was caused by the surgery.

Andrew Campbell, MD · Answer

An injury to the parotid gland and subsequent saliva drainage is an unexpected but real risk of a facelift. If the drainage has stopped and the swelling does not appear to be fluid, it will eventually resolve. The Bell's palsy is concerning, but if you have some motion on that side, it should resolve with time as well. You don't mention how long ago you had your surgery, but keep seeing your surgeon to assure you get the best result you can.Andrew Campbell, M.D.Facial Plastic Specialist

William Marshall Guy, MD · Answer

Hello Chicago911,I'm sorry to hear you have had many of the complications from a facelift.  The parotid gland is a large spit gland that produces saliva.  The treatment is aimed at decreasing the output from the gland which allows the body to then seal off the leak. This is done with pressure, medications, and occasionally Botox.  With appropriate treatment, which sounds like you are receiving, it will eventually go away.  If you are still noticing swelling with eating it means a leak is still present and you should still be treated as above.  With regards to facial paralysis after the facelift it would be important to know if you have a real return of your Bell's palsy (the entire face is weak) or if only a few areas aren't working (stretched nerve at surgery).  The facelift would have improved the slack in your neck and around your mouth and could improve the resting appearance from your history of Bell's palsy.  It will not improve the symmetry with motion.  The eye may have improved as well depending on what surgery was performed in this area.  I hope this helps and good luck.

Peter E. Johnson, MD · Answer

Depending on the type of face lift, if a deeper lift was planned there can be a risk of an injury to the major salivary gland the parotid. The branches of the facial nerve run within the gland, and the facial palsy can be due to swelling, nerve injury, or also the Botox used for the leak in the parotid gland. Bells palsy usually is not a risk form face lifting procedures and has other causes. Work closely with your surgeon as the leak will seal over time and the swelling will resolve.

Jeffrey Marvel, MD · Answer

A salivary fistula is an uncommon but annoying complications after facelift.  They will usually subside in a couple of weeks.  Botox injections, pressure and drains are useful.  In rare situations surgery may be required.  In my practice I have a had a couple over the past couple of years.  They have all closed on their own without the need of surgery.  It can be very frustrating, but usually always resolve without further complications.  Good luck.

Raghu Athre, MD · Answer

Dear Chicago,I'm sorry that you have had so much difficulty after a facelift.  Most facelifts should not be as complicated.  Salivary leak is a real complication of a facelift.  It is not common, but can occur.  Based on your history, everything is being done correctly...(pressure dressings, drain, antihistamines, and BOTOX).  Most salic=vary leaks resolve on with supportive therapy described above.The Bells Palsy is concerning.  The question is if the Bells Palsy started immediately after surgery, after the BOTOX injection, or at some point in the postoperative period.  If the palsy started after the BOTOX or at some point in the post operative period, it should resolve.

I had a full facelift. Afterwards the parotid gland on left side began leaking & I was swollen. Will it go away? (Photo)

Answers (10)

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