Objectives: Long‐term prospective studies on procedure‐related complications after parotid surgery for benign neoplasms (BNs) are scarce. This is the first prospective study on the use of extracapsular dissection (ECD) for BNs, and it aimed to examine the incidence of postoperative complications after parotid surgery for BN.Methods: We collected data obtained in a prospective study of parotidectomy for BN at a university hospital and analyzed the transient and long‐term complications.Results: The incidence rates of transient facial palsy immediately and 18 months after surgery were 15.0% and 3.7%, respectively. The rates of immediate postoperative facial palsy in patients who underwent ECD, partial superficial, superficial, and total parotidectomy were 5.8%, 29.3%, 20.0%, and 44.1%, respectively. Significant risk factors for facial palsy included multiple and larger lesions as well as surgery duration and extension.Conclusions: Postoperative facial palsy remains a common complication after parotidectomy for BN and is associated with the extent of parotidectomy, presence of multiple neoplasms, and operative duration. The results of this study showed that ECD could be a safe technique for avoiding facial palsy.Level of Evidence: 2.

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Purpose: Perioperative antithrombotic protocols for head and neck microvascular reconstruction differ widely across institutions, and the added value of systemic intraoperative heparin is unclear. Methods: We retrospectively reviewed 51 consecutive free flap reconstructions performed in 50 patients between January 2025 and June 2026, comparing reconstructions that received additional intraoperative intravenous unfractionated heparin ( n = 27) with those that did not ( n = 24); all patients received the same standardized postoperative heparin prophylaxis, and comparisons were exploratory. Results: Any postoperative complication occurred in 7 of 27 reconstructions (25.9%) with additional intraoperative heparin versus 7 of 24 (29.2%) without it ( p = 1.000). Hematoma occurred in 2/27 (7.4%) versus 3/24 (12.5%) reconstructions ( p = 0.656), total flap loss in 1/27 (3.7%) versus 2/24 (8.3%) ( p = 0.595), and attempted microvascular revision in 0/27 versus 1/24 (4.2%) ( p = 0.471). Conclusion: In this small, exploratory cohort, adding intraoperative intravenous heparin to an otherwise standardized perioperative regimen was not associated with better early flap outcomes. Given the rarity of flap-related events, the study is underpowered to detect meaningful differences, and the findings should be read as hypothesis-generating rather than confirmatory.