Aesthetic Plastic Surgery

, Volume 35, Issue 4, pp 558–562 | Cite as

Face-Lift Incision Combined With Sternomastoid Muscular Flap in Parotidectomy

  • Keqian ZhiEmail author
  • Wenhao Ren
  • Ling Gao
  • Lu Zhao
  • Shuo Huang
  • Jingwei Li
  • Fang Guo
Original Article



To improve the aesthetic outcome of a traditional parotidectomy, this study used a face-lift incision combined with a sternomastoid muscular (SCM) flap and compared the classical method with these techniques from the patient’s perspective.


Between 2005 and 2007, 38 patients with benign parotid disease underwent surgery. The patients were retrospectively assigned to two groups according to the surgical technique used. Parotidectomy was performed using a combined face-lift incision and SCM flap for 18 patients (modified group). Another 20 patients received classical parotidectomy (Blair incision without reconstruction) (classical group). The patients were followed up every 3 months for 3 years. During the follow-up period, the patients were specifically asked about their satisfaction with their postoperative appearance.


During the follow-up period, all the patients in the group that had the face-lift incision and SCM flap were satisfied with the aesthetic outcome, and the depression deformity was considerably less. Nine patients in the classical group were not satisfied with the aesthetic outcome.


The face-lift incision and SCM flap technique can be performed safely with satisfactory cosmetic and functional results. It results in improved patient satisfaction without additional risk of complications.


Head and neck neoplasms Neck muscles Parotid gland Rhytidoplasty and face 



We thank Dr. Dale A. Baur at the Case Western Reserve University, Divisions of Oral & Maxillofacial Surgery; Professor Daqing Li at the University of Pennsylvania School of Medicine, Department of Otorhinolaryngology–Head & Neck Surgery; Professor Yuming Wen and Longjiang Li in the Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University; and Professors Yincheng Zhang, Sanhu He, Chenqun Hou,Yixi Wen, Gang Li, Jiawei Li, Dong Ma, Zhanping Ren, and Jinfeng Li in the Department of Oral and Maxillofacial Surgery, Stomatological Hospital, College of Medicine, Xi’an Jiaotong University for their assistance in the preparation of this article. This study was supported by the Xi’an Science and Technology Program (SF09030[4], SF1023[5]), Science and Technology Program in Shaanxi Province of China (2009K17-03), an Innovation grant of College of Medicine, and funds of Xi’an Jiaotong University (xjj20100216) . The study also was supported by the Xi’an Science and Technology Program (SF08008-[4]).

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Gutierrez A (1923) Tumores de la glandula parotida: Su extripacion. Rev Cirugia 3:23–27Google Scholar
  2. 2.
    Jost G, Guenon P, Gentil S (2000) Parotidectomy: a plastic approach. Aesthetic Plast Surg 24:1–4CrossRefGoogle Scholar
  3. 3.
    Terris D, Tuffo KM, Fee WE Jr (1994) Modified face-lift incision for parotidectomy. J Laryngol Otol 108:574–578PubMedCrossRefGoogle Scholar
  4. 4.
    Kerawala CJ, McAloney N, Stassen LFA (2002) Prospective randomised trial of the benefits of a sternocleidomastoid flap after superficial parotidectomy. Br J Oral Maxillofac Surg 40:468–472PubMedCrossRefGoogle Scholar
  5. 5.
    Ferreria JL, Maurino N, Michael E et al (1990) Surgery of the parotid region: A new approach. J Oral Maxillofac Surg 48:803–807PubMedCrossRefGoogle Scholar
  6. 6.
    Appiani E (1965) Incision cervico-facial para vaciamiento cervical. Prensa Med Argent 52:371PubMedGoogle Scholar
  7. 7.
    Appiani E (1967) Abordaje para la parotidectomia y transplante muscular. Prensa Med Argent 54:1242–1243PubMedGoogle Scholar
  8. 8.
    Appiani E (1984) Plastic incisions for facial and neck tumors. Ann Plast Surg 13:335–352PubMedCrossRefGoogle Scholar
  9. 9.
    Foustanos A, Zavrides H (2007) Face-lift approach combined with a superficial musculoaponeurotic system advancement flap in parotidectomy. Br J Oral Maxillofac Surg 45:652–655PubMedCrossRefGoogle Scholar
  10. 10.
    Edward WH, Pang PCW, Chu GM (2000) The use of modified rhytidectomy for parotidectomy. Br J Plast Surg 53:80Google Scholar
  11. 11.
    Hǒnig JF (2005) Omega incision face-lift approach and SMAS rotation advancement flap in parotidectomy for prevention of contour deficiency and conspicuous scars affecting the neck. Int J Oral Maxillofac Surg 34:612–618PubMedCrossRefGoogle Scholar
  12. 12.
    Bugis SP, Young JE, Archibald SD (1990) Sternocleidomastoid flap following parotidectomy. Head Neck 12:430–435PubMedCrossRefGoogle Scholar
  13. 13.
    Chow TL, Lam CY, Chiu PW et al (2001) Sternomastoid-muscle transposition improves the cosmetic outcome of superficial parotidectomy. Br J Plast Surg 54:409–411PubMedCrossRefGoogle Scholar
  14. 14.
    Blair VP (1918) Surgery and diseases of the mouth and jaws, 3rd edn. C. V. Mosby, St Louis, MO, pp 492–523Google Scholar
  15. 15.
    Bailey H (1941) The treatment of tumours of the parotid glands. Br J Surg 111:337–346CrossRefGoogle Scholar
  16. 16.
    Kim SY, Mathog RH (1999) Platysma muscle-cervical fascia sternocleidomastoid muscle (PCS) flap for parotidectomy. Head Neck 21:428–433PubMedCrossRefGoogle Scholar
  17. 17.
    Harada T, Inoue T, Harashina T et al (1993) Dermis-fat graft after parotidectomy to prevent Frey’s syndrome and the concave deformity. Ann Plast Surg 31:450PubMedCrossRefGoogle Scholar
  18. 18.
    Timew GC (1994) Sternocleidomastoid muscle flaps following parotidectomy. Br J Oral Maxillofac Surg 32:262Google Scholar
  19. 19.
    Boynton JF, Cohen BE, Barrera A (2006) Rhytidectomy and parotidectomy combined in the same patient. Aesthetic Plast Surg 30:125–131PubMedCrossRefGoogle Scholar
  20. 20.
    Edward WH (2002) Sternomastoid muscle flap for parotidectomy: the pros and cons. Br J Plast Surg 55:88–89Google Scholar
  21. 21.
    Bassoe P (1932) The auriculo-temporal syndrome and other vasomotor disturbances about the head. Med Clin North Am 16:405–407Google Scholar
  22. 22.
    André-Thomas A (1927) Le double reflexe vaso-dilatateur et sudora de la face conse˙cutive aux blessures de la loge parotidienne: Les parareflexes. Rev Neurol 1:447–460Google Scholar
  23. 23.
    Cesteleyn L, Helman J, King S et al (2002) Temporoparietal fascia flaps and superficial musculoaponeurotic system application in parotid surgery reduces Frey’s syndrome. J Oral Maxillofac Surg 60:1284–1297 discussion 1297–1298PubMedCrossRefGoogle Scholar
  24. 24.
    Sinha UK, Saadat D, Doherty CM et al (2003) Use of AlloDerm implant to prevent Frey syndrome after parotidectomy. Arch Facial Plast Surg 5:109–112PubMedCrossRefGoogle Scholar
  25. 25.
    Zhao H-W, Li L-J, Han B et al (2008) Preventing postsurgical complications by modification of parotidectomy. Int J Oral Maxillofac Surg 37:345–349PubMedCrossRefGoogle Scholar
  26. 26.
    Taylor SM, Yoo J, Matthews W et al (2000) Frey’s syndrome and parotidectomy flaps: a retrospective cohort study. Otolaryngol Head Neck Surg 122:201–203PubMedCrossRefGoogle Scholar
  27. 27.
    Wille-Bischofberger A, Rajan GP, Linder TE et al (2007) Impact of the SMAS on Frey’s syndrome after parotid surgery: a prospective, long-term study. Plast Reconstr Surg 120:1519–1523PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2011

Authors and Affiliations

  • Keqian Zhi
    • 1
    Email author
  • Wenhao Ren
    • 1
  • Ling Gao
    • 1
  • Lu Zhao
    • 1
  • Shuo Huang
    • 1
  • Jingwei Li
    • 1
  • Fang Guo
    • 1
  1. 1.Department of Oral and Maxillofacial Surgery/Oncological Head and Neck SurgeryStomatological Hospital, Xi’an Jiaotong UniversityXi’anChina

Personalised recommendations