Patrick J. Louis1* and C Blake Smith2
1Department of Oral and Maxillofacial Surgery, University of Alabama, USA
2Department of Cosmetic and Facial Surgery, USA
Purpose: The aim of this study was to evaluate the complication rates of rhytidectomy alone as a primary procedure versus complication rates of rhytidectomy performed in conjunction with temporomandibular joint replacement (TJR).
Materials and Methods: This study was a retrospective cohort study and consisted of chart review only. The charts of all patients who had a superficial plane rhytidectomy procedure at our institution during the specified time period (July 2000- July 2009) were reviewed. After exclusions were determined, the patients were categorized into two groups, those that underwent the facelift operation as the primary procedure (Facelift group), and those that had it performed as an adjunctive procedure in conjunction with TJR (Facelift + TMJ group). After division of the two groups, the records were examined and data collected on demographics and the complication incidence. The complication categories were consolidated to include 1) Temporary facial nerve injury, 2) Permanent facial nerve injury, 3) Hematoma, 4) Infection and 5) Early Wound Healing Complications (unaesthetic scar, contour irregularities, and flap necrosis), 5) Minor Soft Tissue Complications (minor soft tissue complications that do not fit in the other categories) and 6) Revision rate. A Fisher’s exact test was used to analyze the data. The statistical significance was set at P<0.05.Results: There were 31 patients in the Facelift group and 31 in the Facelift + TMJ group. The mean age of the Facelift group and the Facelift + TMJ group was 58.6+10.82years (Range 30-79) and 46.0+12.73 years (Range 24-76) respectively. In the Facelift group, the majority of cases were bilateral rhytidectomies, with 2 unilateral cases for a total of 60 procedures. In the Facelift + TMJ group, there were 16 bilateral cases and 15 unilateral cases for a total of 47 procedures. No statistical significance was found between the two groups in any of these categories with the exception of temporary facial nerve injury. A statistically significant (p<0.001) increased incidence of temporary facial nerve injury was noted in the Facelift + TMJ group over the Facelift group.Conclusion: Rhytidectomy can be safely performed in conjunction with temporomandibular joint replacement. We did not find evidence to support that performing a facelift as an adjunct procedure increased the complication rate. A much higher incidence of temporary facial nerve injury was found in our patients undergoing facelift as an adjunct procedure when compared to the Facelift group. The cause of this increased incidence is believed to be secondary to the simultaneously TMJ operation, which has a well-known association with facial nerve injury.
Louis PJ, Smith CB. Complication Rates of Facelift Alone Versus Facelift in Conjunction with Temporomandibular Joint Replacement. Clin Surg. 2017; 2: 1398.