Technical tips for a cosmetic approach to parotid surgery.

Purpose Recently, skin incisions have tended to be smaller if surgical exposure is not greatly compromised, especially for benign lesions of the head and neck. An incision in a visible area of the neck needs to be moved to hidden or less prominent sites or away from the head and neck. For aesthetic considerations, the preauricular broken/postauricular trichophytic skin incision was developed for parotid surgery. Patients and Methods This retrospective clinical study enrolled 36 patients (20 women and 16 men) with benign preneural parotid tumors. Six months after surgery, patients were specifically asked to rate their satisfaction with their postoperative appearance on a scale of 1 to 10, with higher scores meaning better patient satisfaction, and whether they would consent to the operation again. Results All patients were satisfied with the cosmetic outcome: 24, 9, and 3 patients rated the procedure 8, 9, and 10, respectively. Conclusions The preauricular broken/postauricular trichophytic skin incision provides generous access to the parotid gland, which is at least as good as the access provided by a Blair incision. It is an aesthetically superior incision that allows good surgical access and improved contour reconstruction.