Aesthetic and Functional Outcomes After Superficial Parotidectomy - Comparison of Three Reconstruction Techniques: An Interventional Clinical Study.

Introduction: Preauricular defects is one of the main concerns after superficial parotidectomy. Plastic surgeons have described many filling techniques to overcome the problem. Objective: To discuss and compare the esthetic and functional outcomes of three postsuperficial parotidectomy reconstruction techniques: partial-thickness, superiorly based sternocleidomastoid muscle flap, en-bloc fat grafting, and platelet-rich fibrin gel. Methods: We included 29 adult patients submitted to reconstruction after superficial parotidectomy by partial-thickness, superiorly based sternocleidomastoid muscle flap, en-bloc fat grafting, and platelet-rich fibrin gel. A subjective evaluation of the overall facial appearance was conducted through a 5-point visual analog scale filled out by the patient, a close relative, and 3 blind staff members. Results: Regarding the visual analog scale, in the comparison between the three groups (at the sixth and the twelfth months), the fat group reported the highest mean for satisfaction (3.4 ± 1.1 and 3.83 ± 0.97 respectively) and showed a highly-significant difference when compared to the sternocleidomastoid muscle flap and the platelet-rich fibrin gel groups ( Conclusion: Parotidectomy with immediate reconstruction of the surgical defect with an en-block fat graft provides better esthetic outcomes than sternocleidomastoid muscle flap and platelet-rich fibrin gel after 1 year. The sternocleidomastoid muscle flap and fat techniques resulted in minimal surgical-site morbidity and lower likelihood of developing Frey's syndrome. The fat graft yielded the best degree of cosmetic satisfaction with minimal morbidity. Fat overcorrection is recommended.