Total parotidectomy causes a significant postoperative concave deformi
ty in the retromandibular, preauricular, and infra-auricular regions o
f the face; many patients are concerned about this defect. Frey's synd
rome (gustatory sweating) is also a well-recognized postoperative enti
ty following parotid surgery. The incidence of Frey's syndrome ranges
from 10-90%, depending on the type and complexity of the investigation
used to diagnose it [5, 11]. Numerous methods have been described to
correct these problems. Patients requiring total parotidectomy were re
cently offered the option of immediate reconstruction of the contour d
efect with microvascular transfer of a tailored gracilis muscle flap.
Four patients are included in this preliminary series, all are extreme
ly satisfied with the postoperative result. The defect following total
parotidectomy can be reconstructed immediately with gratifying cosmet
ic results, a hidden donor site scar, and to date no operative morbidi
ty.