EXAMPLE OF PAROTID SURGERY
The most common incision used for parotid surgery is located along the ear and travels around the ear lobe and then below the jaw bone on the neck. The incision below the jaw is placed in way to try to maximize cosmetic appearance, but the incision will still be visible. The incision shown is a different approach often used by Dr. Denys in patients with favorable features. Dr. Denys was trained in facial cosmetic surgery and this is a face-lift incision that places the incision along the hairline rather on the face-neck region and is the most cosmetic, although more difficult approach to the region.
The face is prepped and draped for surgery. The face is visible in surgery to permit visualization of the facial muscles. A facial nerve monitor is used and small needles (electrodes) are placed into the skin of the forehead, just outside eye, upper lip, and lower lip. Small punctures may be noticed after surgery.
The parotid gland is exposed by lifting the skin as one layer and the muscle layer of the face as a second layer. This helps to minimize any surface changes after removal of the tumor.
The tumor is identified. Most tumors require meticulous and careful dissection in order to remove the tumor and avoid facial nerve injury.
The facial nerve is located and the tumor is dissection away from the nerve until the tumor is free. This is a critical step and may take one or more hours.
A small drain may be placed under the skin to remove fluid. The incision is closed with precision. This requires closure of the muscle layer, deep skin layer, and surface skin using a plastic surgical closure. Dr. Denys takes great care in closing incisions to maximize cosmetic appearance.
Incision two weeks after. The incision will stay red from several weeks to months depending on the patient's age. Care of the incision will be discussed after surgery to maximize healing.