Parotid Reconstruction

Following the removal of the parotid gland due to tumor or infection, a portion of the face is left hollow where the gland used to be. During parotid reconstruction surgery, our team of specialists at the CENTER will correct the defect to restore harmony to the face and prevent long-term complications.

WHY IS PAROTID RECONSTRUCTION NECESSARY?

When the parotid gland is removed during a parotidectomy and a reconstructive procedure is not immediately performed, patients commonly experience a dramatic change in their appearance. In many cases, they are left with a hollow divot that results in an asymmetrical appearance, as well as sagging skin from the removal of an excessively large parotid gland and tumor.

Additionally, failure to reconstruct the area means that the delicate facial nerve is now exposed, covered only by a thin layer of skin. This can lead to the development of Frey's Syndrome - a condition in which the facial nerve branches that aid in saliva production inside the parotid gland start to grow into the skin and attach to the sweat glands. This causes excessive sweating on the side of the face when the patient is hungry or eating. Performing parotid reconstruction at the time of the parotidectomy prevents the patient from developing Frey's Syndrome.

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THE PAROTID RECONSTRUCTION PROCEDURE

Dr. Larian and Dr. Babak Azizzadeh, a renowned facial plastic surgeon, perform parotid reconstruction immediately after removing the parotid tumor. Completing both procedures simultaneously provides patients with the following benefits:

• Less risk of injury to the facial nerve. There is a heightened risk of complications associated with a second surgery involving the facial nerve, because some of the branches may be hidden within the scar tissue.
• An optimal cosmetic outcome, as the surgeon has a better chance of creating symmetry on both sides of the face.
• The prevention of Frey's Syndrome.
• Quicker healing and recovery time.
• Less exposure to anesthesia.

Once Dr. Larian has removed the affected portion of the parotid gland, leading facial plastic surgeon, Dr. Azizzadeh will begin the aesthetic reconstruction portion of the surgery. Guided by photos of the patient taken from several different angles, he will then reconstruct the area to ensure the patient's cosmetic appearance is unchanged following surgery. To begin, Dr. Azizzadeh will separate a small portion of the Sternocleidomastoid Muscle (SCM), which is one of the muscles that controls movement of the neck and is located right behind the parotid gland, and rotate the SCM over the facial nerve. Placing the SCM here will not only help prevent Frey's Syndrome, but it will also fill in the hollow left from the removed tumor to restore harmony and symmetry to the face. If sagging skin is present due to the removal of a large parotid gland, Dr. Azizzadeh will trim away the excess skin before closing the incisions. In other cases, he may contour both sides of the face to ensure the best possible result from your parotid reconstruction.

In rare cases when the parotid gland was excessively large, the SCM muscle may not adequately fill the divot. In these cases, Dr. Azizzadeh will use graft material such as acellular dermis, which is the protein portion of the skin without any live components. This graft will integrate permanently into the normal tissues and provide extra volume to the hollow area. With an emphasis on achieving both an optimal surgical and cosmetic outcome, Dr. Larian, Dr. Azizzadeh and the entire team at the CENTER have developed a reputation for providing the best parotid surgery available.