Parotid gland damaged lower facelift. Am I likely to need more surgery? (Photo)

Question

My surgery was July 24th and it has now been determined it is definitely a parotid gland injury. This past Friday, my doctor drained and injected Botox and a drain tube to remain in for ten days. I am also taking Glycopyrrol 1mg three times a day. I have noticed little change since Friday and am not getting enough fluid in the drain tube to even measure. I am terrified I am going to have to have more surgery and my face will end up looking worse than it did before my facelift.

Cameron Chesnut, MD, FAAD, FACMS · Answer

Parotid gland issues are very rare after facelift surgery, but they do happen and most experienced facelift surgeons have experience in managing this issue. The methods to manage are extrapolated from other, non-cosmetic surgeries that purposefully involve the parotid. 
First and foremost, this is almost always temporary. Conservative management, as outlined below, is your best option while it resolves. Occasionally when the parotid duct is injured, it needs to be repaired, but this is usually a process of elimination, and it can be looked at with a radiology study. 
Conservative treatment includes means to stop saliva production:Botox into the glandScopolamine patchesAntihistaminesEating a bland diet and avoiding sour, acidic or spicy foods
In addition, any fluid accumulation needs to be drained regularly. A temporary drain and compression may be useful. 
To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.
Cameron Chesnut #realself500 Physician

Thomas P. Sterry, MD · Answer

This is a fairly unusual case, but the treatment has been well described because of work done directly on the parotid gland in non-cosmetic cases.  It seems like all of the right steps were being taken back in August including the use of botox and various medications to decrease salivary secretions.I would love an update to know what has happened since, I hope/trust that you are improving and are well at this point.

Stephen Prendiville, MD · Answer

Based on the description of your case, I would recommend use of Botox at this point.  The parotid gland salivary producing mechanism relies on a cholinergic receptor, one that is bound by Botox. This will slow salivary production and help the process along. This will get better with time, so try to be patient and keep close contact with your Surgeon.

Gary L. Ross, MBChB, FRCS · Answer

Sorry to hear of this unusual complication. It sounds like your surgeon is treating you appropriately by trying to reduce the secretions from the parotid gland. This is likely to resolve without any further treatment and you should keep in contact with your PS.

Eugene L. Alford, MD · Answer

Having seen and managed 3 of these cases in the past I would say you are being treated the proper way. The only thing I would add is a gentle compression dressing and a bland diet. Botox is the key to get the salivary fluid out put to stop. Once that had been done it can take up to a  week to see the fluid output go down. It is unlikely your will need more surgery. Patience is the key along with proper use and dose of Botox, a pressure dressing bland diet and tincture if time.

Parotid gland damaged lower facelift. Am I likely to need more surgery? (Photo)

Answers (6)

Answer: Salivary collection

Answer: Salivary collection

Answer: Parotid gland injury after facelift.

Answer: Parotid gland injury after facelift.

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Parotid gland damaged lower facelift. Am I likely to need more surgery? (Photo)

Answers (6)

Answer: Salivary collection

Answer: Salivary collection

Answer: Parotid gland injury after facelift.

Answer: Parotid gland injury after facelift.

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Recommended reading

Everything you need to know about Lower Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.