Parotidectomy is a surgical procedure associated to functional (Frey’s syndrome) as well as aesthetic (facial asymmetry) complications that can be very disturbing for the patient. Several procedures have been described to primarily avoid or secondarily reconstruct the facial defect and treat the neurological iatrogenic syndrome. Autologous fat transfer was primarily used in 10 cases to avoid such complications. It is an easy technique widely used in cosmetic and reconstructive surgery. This technique gives very satisfying long-term results on the cosmetic as well as on the physiological point of view. 1. Introduction Superficial or total parotidectomy is a common procedure associated with some possible complications as well as functional and aesthetic consequences. Among these, Frey’s syndrome, also called gustatory sweat syndrome or auriculotemporal syndrome, and a preauricular deformity are common issues that can lead to very disturbing clinical situations. Indeed, Frey’s syndrome is characterized by a sweating and a flushing and/or an erythema of the cheek area during mastication after parotid surgery. Aesthetic consequences include a concave facial effect with facial asymmetry (Figure 1) and prominent scar. Several procedures have been developed to primarily avoid or secondarily reconstruct the facial defect and treat the neurological iatrogenic syndrome. Figure 1: 56 year-old patient, one year after a left parotidectomy without any primitive reconstructive procedure, presenting an obvious concave preauricular deformity. A secondary lipofilling was performed, leading to a permanent facial paresis and a poor cosmetic result. Autologous fat transfer, also called fat graft or lipofilling following the operative technique used, is an easy technique widely used in cosmetic surgery to correct folds of the face (nasolabial folds, etc.) or to remodel soft tissue and enlarge or resurface them. This technique was primarily applied in 10 cases of superficial and total parotidectomy, with very good to excellent long-term results on the cosmetic as well as on the physiological point of view. 2. Material and Methods Ten patients (4 males and 6 females) were operated on from January 2006 to December 2009 for clinically benign tumors of the superficial and/or deep lobe of the parotid gland. Dissection of the parotid was performed under magnification, with dissection and preservation of the facial nerve in all cases. Before closing the operative field, fat was harvested in the lower abdominal wall following Coleman’s technique: after infiltration of the site of fat
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