Complications of parotid surgery

The facelift incision and allograft dermis implants have been used in parotid surgery to improve esthetic outcomes. We commonly use these techniques in patients with benign parotid tumors. Forty-two percent of our parotidectomy patients have had facelift incisions, and 50% have had allograft dermis implants for reconstruction. The rate of temporary facial nerve paralysis was 64% for the modified Blair incision and 28% for the facelift incision. We did not have any patients with superficial parotidectomy for benign tumors with long-term facial paralysis. Our rate of Frey's syndrome was low (14%) but did not differ between patients with and without allograft dermis implants. In patients with allograft dermis implants, the initial rate of seroma/salivoma was 45% but decreased to 19% with prolonged drainage and antibiotics. In this patient population, we believe that the risk of complication is outweighed by the improved esthetic outcomes.