Modified overlap SMAS flap in the treatment of facial depression after resection of benign parotid lesions

Abstract Objective The purpose of our study was to evaluate the clinical effect of a facelift combined with a modified overlapping superficial musculoaponeurotic system (SMAS) flap for repairing facial depression caused by the resection of benign parotid lesions. Methods This retrospective, non-randomized observational study included 87 patients diagnosed with benign parotid tumors who underwent surgical treatment between June 2014 and September 2023. All patients were treated in our department or by the same surgical team after institutional transfer. All patients received surgery via a standardized facelift incision approach.; All patients underwent surgery using a standardized facelift incision. Of them, 58 patients received reconstructive surgery with the modified SMAS flap, and 29 patients were treated using the classical SMAS flap. The degree of satisfaction with scarring and facial depression was assessed 6 months postoperatively using the Vancouver Scar Scale (VSS) and a 10-point scale (0 = no obvious depression; 10 = severe depression), respectively. Results There was no significant difference regarding the degree of satisfaction with scarring between the two groups (P > 0.05), while the modified SMAS flap group was significantly more satisfied with the facial depressions than the classical SMAS flap group (P < 0.001). Surgical complications and tumor recurrence were not significantly different between the two groups. Conclusions A facelift combined with a modified SMAS flap can effectively repair the facial depressions caused by the resection of benign parotid lesions and achieve good aesthetic results.