Archives of Aesthetic Plastic Surgery  2014;20(2):120-123

doi:10.14730/aaps.2014.20.2.120

Treatment of Botulinum Toxin Type A in Parotid Fistula after Face Lifting.

Min Su JUNG 1 ; Byeong Ho LEE ; Joo Hyun KIM ; Seong Hoon PARK ; Duk Kyun AHN ; Hii Sun JEONG ; In Suck SUH

Affiliations

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Keywords

Botulinum toxin A; Facelift; Fistula; Parotid gland

Country

Republic of Korea

Language

English

Abstract

Botulinum toxin type A has an inhibitory action not only on neuromuscular junctions, but also postganglionic sympathetic and cholinergic autonomic parasympathetic acetylcholine release at the secretary end of the salivary gland. Use of botulinum toxin to treat sialorrhea was first reported in 1997 by Bushara. Parotid duct or gland injuries with parotid fistula are uncommon but troublesome complications of surgical trauma. Here, we report two patients with constant leakage of serous fluid and a swelling cheek after facelift surgery. Each patient underwent an amylase test, starch iodine test, and sialography. After diagnosis of parotid fistula, a total of 50 units botulinum toxin was injected into the parotid gland. Facial bandage, scopolamine, and minimizing temporomandibular joint motion were instructed. Leakage volume decreased gradually, and symptoms subsided within 2 weeks. Neither functional problems nor complications occurred. In conclusion, a parotid fistula after facial surgery can be treated effectively with botulinum toxin; this treatment option should be considered before proceeding with invasive surgical treatment.