Are elective facelifts a good idea after head and neck cancer radiotherapy?
Reviewed by Bilal Gani Taib

The aim of this study was to assess the safety of elective cervicofacial rhytidectomy following radiotherapy for head and neck squamous cell carcinomas (HNSCC). A greater proportion of HNSCC patients are infected with certain strains of the human papillomavirus, which causes more than half of all cases of oropharyngeal cancer. These patients frequently do not have the typical risk factors for HNSCC and are being cured. This cohort increasingly desire elective rhytidectomy following treatment as they are unhappy with their aesthetic outcomes following treatment. In this case control study there were 16 patients in the radiotherapy group and 16 in the control group who underwent elective cervicofacial rhytidectomy. Patients who received chemotherapy and radiotherapy were more likely to have complications (p=0.04) as were patients post radiotherapy who underwent rhytidectomy using a subcutaneous technique after (p=0.02). No major complications occurred in the control group but two major complications (12%) occurred in the case group (stroke and evacuation of a haematoma). Being older and the time from completion of radiotherapy and surgery did not show any correlation to complications. In conclusion, this study, albeit with small numbers, has highlighted that aesthetic facial surgery after radiotherapy is associated with an increased risk for complication compared with facial surgery without radiotherapy.

Cervicofacial rhytidectomy after radiotherapy for head and neck tumors.
Wudel JM, Novis S, Baker SR, et al.
JAMA FACIAL PLASTIC SURGERY
2016;18(1):9-14.