S-shaped Incision versus Facelift Incision for Parotid Surgery

Background: S-shaped incision (SI), which provides excellent surgical access to the parotid gland, is conventionally used for parotid surgery, but it leaves a visible scar in the neck, producing esthetic problems, especially in young persons. As an alternative, therefore, the facelift incision (FLI), which leaves an inconspicuous neck scar, is often considered. The objective of this study was to compare the tumor characteristics and surgical outcomes between patients who received these two incisions for parotid surgery. Materials and methods: In this retrospective study, we analyzed the data of 69 patients with benign parotid diseases who had undergone parotidectomy at our hospital over the past 1 year 9 months. The FLI was mainly applied for relatively small, benign lesions located in the superficial lobe posteriorly or in the tail of the parotid gland. Result: Of the 69 patients, 55 patients received the SI (SI group) and 14 received the FLI (FLI group). The median tumor size in the SI group was larger than that in the FLI group, with a significant difference between the two groups (35 mm and 22 mm, respectively; P＝0.04). The frequency of deep-lobe location was not significantly different between the two groups (SI vs. FLI: 22% vs. 14%; P＝0.72). The average operating time by the same surgeon was 134 min in the SI group (n＝46) and 139 min in the FLI group (n＝14), without significant difference (P＝0.73). Postoperative facial nerve palsy was observed in 6 patients (10.9%) in the SI group, but none of the patients in the FLI group. One patient with diabetes mellitus in the FLI group showed postoperative ischemia at the distal end of the flap in the retroauricular region, which left a hypertrophic scar. There were no significant differences in the frequencies of other complications such as salivary leakage or Frey's syndrome between the FLI group and the SI group. Conclusion: Facelift incision is a safe and aesthetically superior approach for benign parotid disease.