Step 5 Closure

Deep closure is performed as described for the retromandibular approach. After the parotid capsule/SMAS/platysma layer is closed, a 1/8- or 3/32-in. round vacuum drain is placed into the subcutaneous pocket to prevent hematoma formation. The drain can exit the posterior portion of the incision or a separate stab in the posterior part of the neck. A two-layer skin closure is performed (Fig. 11-6)._

Figure 11- 6 Closure and subcutaneous drain placement.

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