Can a deep plane facelift be performed 2.5 years after a parotidectomy? (photos)

It is true that having had a parotidectomy puts you at higher risk of nerve damage as the facial nerve and its branches run through the parotid gland. It would be important to know if you had a superficial or total parotidectomy as this would indicate how much of the parotid gland was removed. Either way, a facelift may still be performed by an experienced and skilled facelift surgeon who is comfortable with the facial nerve anatomy.

Thank you for your question. There are several factors to consider regarding the decision to undergo a deep plane facelift following a parotidectomy.

First, ensure that the issue for which the parotidectomy was performed is unquestionably resolved and that you are not undergoing elective surgery in an area still monitored for more serious problems.

Second, accessing the area where the parotidectomy was performed can be necessary for various reasons, including issues with gustatory sweating or Frey’s syndrome. While it does present a higher risk, it is not an impossible task.

Thirdly, the layer where the deep plane suspension is carried out may have been affected by the parotidectomy and may no longer be as robust. Passing sutures to anchor the deep plane facelift in this area could potentially cause problems.

It is technically possible to achieve significant improvements with superficial facelifts. If you consult with an experienced facelift surgeon, they may recommend a deep plane facelift on the side where no surgery was performed and a superficial or skin-only facelift on the side where you had the parotidectomy.

These solutions are bespoke and cannot be addressed with a simple generic statement, but overall, there are solutions for many situations along these lines.

Can a facelift be performed after a parotidectomy and have I performed a facelift in such situations?
Absolutely.
However, the photos provided are not convincing that such a procedure is indicated and a consultation would be necessary.

Hi! Some of this depends on what kind of parotidectomy you had and why you had it (such as cancer). Based on your photos, it looks like you only had a partial/superficial parotidectomy (compared to a more extensive total parotidectomy). If that is the case, that varies how much of the nerves are exposed. Regardless, if you understand that the nerves are just at slightly higher risk, then it actually should not make a significant difference since usually the entry into "the deep plane" happens past where the parotid would exist anyway. I would absolutely make sure you go to a surgeon who thoroughly understands the facial anatomy, feels comfortable doing this to you given your history of the parotidectomy, because this definitely puts you at higher risk but you can get it done. I would strongly recommend you go to a facial plastic surgeon who had training in ENT/otolaryngology because they would be even more familiar with the nuances of the parotid portion of the surgery than most general plastic surgeons. Good luck!

A facelift can be performed. This usually requires a highly trained plastic surgeon with a predominantly facelift practice. I would recommend facial nerve monitoring intraoperatively at a minimum.

I think that any facelift following parotid surgery carries some risks. The layer that is typically dissected under for a deep plane facelift has been violated by the parotid surgery and the facial nerve is likely just under the skin in the area in front and just beneath your ear lobe. You can certainly have a facelift, and the neck portion can be performed in the deep plane, but the portion of the facelift that addresses your jowls and cheeks would more likely need to be addressed in a different plane.

I wouldn’t worry about the deep plane aspect of the facelift. The facelift can be done it just needs to be very conservative to avoid injury to the nerves on the side with the parotidectomy.

Yes indeed, a facelift can be performed after a parotidectomy. In our practice, we have done several of these successfully in last 25 years. Make sure you find a surgeon who is very familiar with the facial nerve anatomy, and preferably a surgeon who performed parotidectomy's in the past and understands how to go about performing a facelift after that procedure. In addition, if you have sweating every time you're eating over that area, that can be corrected as well.