[The SMAS (subcutaneous musculo-aponeurosis system) flap: a possibility for filling out soft tissue defects after parotidectomy].

[BACKGROUND] Parotidectomies sometimes leave a conspicuous soft-tissue defect in the dorsal part of the cheek.

[METHODS] The authors present a modification of the standard technique of parotidectomy which is reserved for the surgical management of benign parotid tumors. The incision of the skin follows the guidelines for standard subcutaneous rhytidectomy with a modification according to the Redon incision. They use flaps of the subcutaneous musculoaponeurotic system (SMAS), which they fold or rotate in order to fill the soft-tissue defect following parotidectomy. The preparation of the skin and the SMAS in layers from the lateral to the medial aspect of the cheek does not affect the blood supply which comes from medially running vessels.

[RESULTS] Forty patients have been operated on using these modifications of the standard technique. A postoperative follow-up of more than one year could be controlled in 31 cases. Thirty patients showed an inconspicuous dorsal region of the cheek without a soft-tissue defect compared to the other side. They did not wish a secondary operation for an aesthetic improvement except two scar revisions.

[CONCLUSION] To date this surgical concept has proved its worth.