Postauricular skin slough in cervical facial rhytidectomy

Postauricular skin slough in cervical facial rhytidectomy is a well-described complication, but statistics on its incidence are hard to obtain. Although technical errors are usually blamed for causing this condition, the exact causes remain vague. Previously described causes include thin dissection of the skin flaps, an acute angle in the configuration of the postauricular skin incision, trauma to the skin flap with instruments or digital pressure, hematoma under the flap, smoking in the postoperative period, and excessive tension by inappropriate placement of the anchor stitches in the postauricular area. Postoperative head position may be another key factor in the development of postauricular skin slough. Strict postoperative counseling should be employed to help avoid this complication.