Sialendoscopy as treatment of face aesthetic surgery complications: technical note

OBJECTIVE: The demand for cosmetic surgery on the face and body has increased worldwide. Brazil is currently the world leader in open plastic surgery and second on facelift, buccal fat removal, injectables (fillers), and thread lifts. The incidence of injuries to salivary glands, ducts, and facial nerves related to cosmetic procedures is uncommon but devastating. Treatment includes dressings, botulinum toxin, anticholinergics, drainages and salivary gland resection. Sialendoscopy has been successfully described for the treatment of ductal diseases with gland preservation. We present five cases of salivary duct injury after facial cosmetic procedures treated with sialendoscopy (gland preservation) and review of the literature. METHOD: Retrospective single-center case series of 5 patients who underwent sialoendoscopy, with/without combined open access, for salivary duct lesions treatment following facial aesthetic procedures. Clinical data, type of procedure, ductal lesion and outcome were examined. The diagnosis was based on clinical history, procedure, clinical and radiological examination. Our Protocol Technical Note of Sialendoscopy and Combined Access is described. RESULTS: 228 sialendoscopies were performed in 11y period, only 5 (2.2%) for complications from facial cosmetic procedures. 80% women, age 48 y. CLINICAL PRESENTATION: facial edema, painful bulging, secretion from incision, facial paralysis. Fillers were used in 80%, 20% underwent buccal fat pad removal and 40% deep-plane facelift. Ductal injury occurred in 100%, 40% total section, 20% partial section, 20% facial nerve injury. Sialendoscopy treatment were used in all cases, 40% in fillers and 60% associated with face lifting open access. Salivary gland preservation was achieved in 100% patients. To date, only 27 patients have been described in the literature. CONCLUSIONS: Sialendoscopy as soon as possible remains a treatment option for preserving gland function with a high success rate and minimal complications. The favorable outcome reflects the team's experience in managing face aesthetic surgery complications with the use of sialendoscopy.