Can I have a facelift after a superficial parotidectomy?

Facelift after a parotidectomy is not only quite possible in experienced hands, it is the ideal time to reconstruct the sunken area and cover any exposed facial nerves with grafts and small internal flaps.  Doctors performing this reconstruction should be comfortable performing nerve repairs, parotidectomies and neurolysis procedures.

You can have a facelift after parotid surgery.  The problem the parotid surgery poses is that it makes the facial nerve more susceptible to injury during facelift surgery. Depending on the situation , the facelift will probably need to be a somewhat conservative lift in order to inimize that risk.  Also you will probably need to wait until a full year to have the facelift performed.  Good luck!

     I would not recommend a facelift after parotidectomy due to facial nerve concerns.  Kenneth Hughes, MD Los Angeles, CA

Can you have a facelift after parotidectomy? The answer is Yes but the recommendation in NO. If you have had a superficial or total parotidectomy ,your facial nerve is lying literally millimeters below the skin of your face. Although its technically possible , the risk to damaging your facial nerve is very significant and to be honest unacceptable. 

This is a question that comes up in our practice once every few years.

Yes it is possible to perform a facelift after superficial parotidectomy.

BUT, I do not think it is a good idea. The anatomy of the facial nerve branches is altered. Commonly, the nerve is now encased by scar tissue and is located rather superficially underneath the skin.

A much better approach would be to discuss a possible later facelift with your head & neck surgeon before the parotidectomy. In that case, the surgeon can take some pre-emptive measures at the time of facial nerve dissection.

Many other treatments for facial rejuvenation can be performed for you. Personally, I have safely performed necklift surgery after parotid tumor surgery.

There is Increased Risk for Facelift after a superficial Parotidectomy as the facial nerve is now lying just below the fat layer so more prone to be injured. I have however successfully perfomed facelifts following this procedure. This is the advise I would give: Wait a minimum of one year, then seek a board certified plastic surgeon who is well versed with facial nerve surgery and parotid surgeries for consultation. He/She will want to see a copy of your prior surgical note and pathology reports and examine you  prior to making a recommendation

This is possible and the risk depends on whether the facial nerve was dissected out during the parotid surgery.  A review of the operative report would be helpful

While it is possible to perform a facelift on a patient who has had a superficial parotidectomy, in most cases the risk/benefit ratio would not justify such a course of action. This is because a superficial parotidectomy causes the facial nerve to lie in a more superficial position in a portion of its course. This increases the risk of transection of the facial nerve during the course of a facelift,which is the most feared complication associated with this type of surgery. It is difficult to justify undertaking such additional risk for what is essentially an elective cosmetic procedure.

 

Happily, we now can offer such patients some excellent alternative procedures, which carry much less associated risk. The first would be an endoscopic midfacelift. In this surgery, the dissection is performed at a level safely below the position of the facial nerve.This could be combined with a corset platysmaplasty of the central neck and liposuction of the neck, submental area and jawline. The fat harvested from the liposuction could then be used for fat transfer to the face to increase facial volume and add a final touch to the synergistic effect of these procedures. So even though a facelift after a superficial parotidectomy would be unwise, there are many ways to skin a cat--while leaving the facial nerve unharmed!

The minimum operation that you would have received is a 'superficial parotidectomy.' This leaves the branches of the facial nerve immediately below the skin, obscured by scar, and very difficult to identify even by the surgeon who did the surgery in the first place. Damage to the facial nerve is not a slightly elevated risk - it is clear and present danger!  My advice is to consider some alternate means of facial rejuvenation.

One of the most devastating complications after a facelift is an injury to the facial nerve.  An injury to the nerve, permanently paralyses a section of the face.  After a superficial parotidectomy, the location of the facial nerve location will change and it can be in many different places.  It can be deep in the tissue or close to the skin.  This places the nerve at a higher chance of injury.   

 

It is possible to do a facelift after a parotidectomy, but there are increased risks.  I would discuss this with your surgeon to see if this is still a procedure for you.

 

I hope this helps!