I Had Facelift 2.5 Weeks Ago and Now Have a Leaking Parotid into Cheek. Recommendations?

I am using pressure, taking drugs to slow saliva, and getting nourishment through a straw so as not to encourage saliva. I have had many aspirations. Any additional ideas would be greatly appreciated. 3ccs were removed two days ago. It seems as though this might be quite rare. The rest of my procedure is really terrific and I healed quickly with very minor bruising.

Doctor Answers 10

Parotid gland leak

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Sorry to hear you are having a problem after your facelift.  This is usually a temporary problem as the other responders have stated. There is some evidence that Botox may help this problem. I would give it a little more time.  It sounds as though you are managing and doing all of the right things.

Thank you for your question and hang in there.  Keep in close touch with your plastic surgeon.

Fort Myers Plastic Surgeon
4.8 out of 5 stars 69 reviews

Treatment of Parotid Leak After Facelift

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While a parotid sialocoele is a rare occurrence after a facelift, it can happen since the plane of dissection goes right over the parotid fascia and the raising of the SMAS is right in front of itThey will almost always resolve on their own with aspirations and time. There is certainly nothing to lose with Botox injections although that could have its own side effect if branches of the facial nerve get treated as well. If it fails to resolve in 3 to 4 weeks after surgery, it can be fairly easily cured by the placement of an allogeneic dermal graft (e.g. alloderm) over the parotid to seal it off.

Botox may be helpful for a leaky parotid salivary gland after facelift surgery.

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Your salivary gland leak is certainly a nuisance, but this will slowly resolve. Adequate compression is difficult, and needle aspirations are necessary. Frequent follow-up with your doctor for serial aspirations should lead to less and less fluid collection. Though I have no personal experience with this, Botox has been described as helpful for facilitating resolution.

All the best.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

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Parotid leak after facelift

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this is a rare occurance.  it is generally self limiting. percutanenous needle aspiration may be required and may be required more than once. pressure is also helpful.

Adam Bryce Weinfeld, MD
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Buildup of Fluid in the Cheek after Facelift

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In addition to periodic aspiration and compression bandages at night, Botox injected into the parotid gland could be helpful if you are truly having salivary fluid leaking. You can test the fluid after aspiration for amylase to verify that it is a salivary leak and not a recurrent seroma. I would recommend close follow up with your surgeon to help this problem resolve as quickly as possible.

Temp Patterson, MD
Burley Facial Plastic Surgeon

Leaking Saliva from Parotid Gland after Facelift

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Leaking saliva from parotid gland after facelift is rare complication of this surgery. On each side of the face the parotid gland is covered by a layer of tissue call SMAS and subcutaneous fat and skin. During facelift if the SMAS is elevated to be pulled back , there is a possibility to penetrate a parotid duct that will leak saliva under the skin. This leakage will eventually decrease and stop. Follow your plastic surgeon advise as you are doing, also refrain form eating or drinking any food or  drink that stimulate saliva production : no citrus

A. H. Nezami, MD
Jacksonville Plastic Surgeon

Salivary leak vs. seroma

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A salivary leak is a rare side effect but it should resolve over time.  Periodic aspirations and compression are helpful.  Follow up with your surgeon.

Sam Naficy, MD, FACS
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Parotid fistula

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These are very rare and usually cure themselves in time. Ascopalomine patch heps in decreasing saliva..It is temporary don't worry

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 30 reviews

Parotid fistula after facelift

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After 20 years in practice and a lot of facelifts I got my first parotid fistula about 4 months ago. It was not from a deep plane facelift. It successfully stopped after about 6 weeks as I recall. I had my patient use a Scopalamine patch and adhere to a very bland diet. I don't think the straw has anything to do with it. I was quite certain that I had not injured the major duct. If that is a concern there is an X-ray test you could get. For now I would just follow your surgeon's instructions. Good luck.

Parotid gland fistula

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I think that every Plastic Surgeon who has been in practice for many years has had to experience this in a patient or two.  The more common  reason for this limited complication is to have this occur after a deep plane facelift, dissecting directly over the parotid gland.  Occasionally injuring  an accessory portion of the parotid gland in the area below the earlobe or preauricular area may lead to this as well.  My experience is that these  problems will spontaneously heal after a short period of time with compression and occasional needle aspiration to reduce the collection of parotid  fluid.  Another simple way to reduce the fluid accumulation is to place a small drain under the skin close to the ear or wherever the fluid accumulation is noted.  The regular drainage will reduce the fluid and let the skin seal quickly to the deeper tissue very quickly.  Please appreciate that this is a very temporary problem and will correct itself rapidly with  the mentioned conservative treatments.


Good luck to you, and let your Plastic Surgeon  assist you with this  minor problem.


Frank Rieger M.D.  Tampa Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.