The most commonly used incision for parotidectomies is the modified Blair incision. We have successfully used an alternative incision which allows good exposure, and leaves no neck scar. Between 1 March 1989 and 1 August 1991, 18 parotidectomies were performed using a modified facelift incision. Fifteen parotidectomies were done for similar indications during the same period using a modified Blair incision. The mean age in both groups of patients was 40.3 years. The pathology and incidence of complications was similar in the two groups. The difference in mean (+/- SD) time of surgery between the two groups was not statistically significant: 3.14 +/- 0.75 hours in patients with a modified facelift incision and 3.25 +/- 1.27 hours in patients with a modified Blair incision (p > 0.1). The modified facelift incision is an alternative approach to parotidectomy for selected patients. It provides adequate exposure, even for a total parotidectomy and mastoidectomy and it results in improved patient satisfaction without additional risk of complications.