Skip to main content

Facelift Surgery Following Superficial Parotidectomy: Is it Safe?



Patients who have previously undergone superficial parotidectomy may also seek facelift surgery for facial aging and rejuvenation. These patients present unique challenges compared to a standard facelift patient. Most concerning is the location of facial nerve branches, which may be superficial and displaced. In addition, significant contour deformities and abnormal scar patterns may be present. The purpose of the study is to review our series of patients and assess potential morbidity and safety of facelift surgery in superficial parotidectomy patients.


A retrospective case series was performed reviewing all patients who underwent facelift surgery following superficial parotidectomy from 2000 to 2017. Data were collected for: postoperative facial nerve deficit, soft tissue contour and scar deformities, facelift technique, ancillary soft tissue augmentation procedures and pre- and postoperative photographs. An evidence-based treatment algorithm to address specific problems in this patient population was developed.


A total of seven patients were identified who underwent facelift surgery following parotidectomy. Patients underwent one of the standard SMAS procedure on the non-parotidectomy side, and surgical modifications were made to address the parotidectomy side; soft tissue augmentation was performed in two patients. Precautions to identify the facial nerve and prevent injury, including nerve monitoring and stimulation, were utilized in all seven patients. No permanent postoperative facial nerve injury was noted.


Facelift following superficial parotidectomy was safely performed in all cases. Special consideration should be given to contour deformities, facial nerve location and scar placement. However, if approached properly, these patients can still be considered as suitable candidates for facelift surgery.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2


  1. Baj A, Beltramini GA, Demarchi M, Combi VA, Gianni AB (2011) Bilateral SMAS rhytidectomy in parotid recurrent pleomorphic adenoma. Acta Otorhinolaryngol Ital 31(4):256–258

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Barrett BM Jr, Rose FA (1984) Aesthetic cervicofacial surgery for head and neck tumor patients. Aesthetic Plast Surg 8(2):123–128

    Article  Google Scholar 

  3. Boynton JF, Cohen BE, Barrera A (2006) Rhytidectomy and parotidectomy combined in the same patient. Aesthetic Plast Surg 30(1):125–131

    Article  Google Scholar 

  4. Jost G, Guenon P, Gentil S (1999) Parotidectomy: a plastic approach. Aesthetic Plast Surg 23(1):1–4

    CAS  Article  Google Scholar 

  5. Bravo FG (2013) Submandibular and parotid gland reduction in facelift surgery. Plast Reconstr Surg 132(4S-1):95–96

    Article  Google Scholar 

  6. Garden AS (2010) Chapter 8—The salivary glands. In: Cox JD, Ang KK (eds) Radiation oncology, 9th edn. Content Repository Only, Philadelphia, pp 169–182

    Google Scholar 

  7. O’Brien CJ (2003) Current management of benign parotid tumors–the role of limited superficial parotidectomy. Head Neck 25(11):946–952

    Article  Google Scholar 

  8. Woods JE, Chong GC, Beahrs OH (1975) Experience with 1360 primary parotid tumors. Am J Surg 130(4):460–462

    CAS  Article  Google Scholar 

  9. Sundine MJ, Kretsis V, Connell BF (2010) Longevity of SMAS facial rejuvenation and support. Plast Reconstr Surg 126(1):229–237

    CAS  PubMed  Google Scholar 

  10. Vico PG, Delange A, De Vooght A (2014) Autologous fat transfer: an aesthetic and functional refinement for parotidectomy. Surg Res Pract 2014:873453

    PubMed  PubMed Central  Google Scholar 

  11. Dell’Aversana Orabona G, Salzano G, Abbate V et al (2015) Use of the SMAS flap for reconstruction of the parotid lodge. Acta Otorhinolaryngol Ital 35(6):406–411

    PubMed  PubMed Central  Google Scholar 

  12. Nofal AA-F, Mohamed M (2015) Sternocleidomastoid muscle flap after parotidectomy. Int Arch Otorhinolaryngol 19(4):319–324

    Article  Google Scholar 

  13. Winstead JM, Olson GT, Frodel JL (2012) Reconstruction of periparotid defects using temporoparietal fascia flap with layered acellular human dermal allograft. Craniomaxillofacial Trauma Reconst 5(1):19–24

    Article  Google Scholar 

Download references



Author information

Authors and Affiliations


Corresponding author

Correspondence to James E. Zins.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

This study was obtained retrospectively under the use of Cleveland Clinic Institutional Review Board, document #15-1248.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Cummins, A.J., Surek, C.C., Charafeddine, A.H. et al. Facelift Surgery Following Superficial Parotidectomy: Is it Safe?. Aesth Plast Surg 44, 354–358 (2020).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Facelift
  • Parotidectomy
  • Facial nerve
  • Parotid tumor
  • Facial aging
  • Parotid
  • Rhytidectomy