Submandibular or submaxillary glands can be removed as a procedure with facelifting. Most surgeons who remove these glands remove only a portion of the gland and not the entire submaxillary gland. If the gland is especially large, their presence can sometimes provide less impact to a rejuvenated face. On the other hand, their are more risks with submandibular gland removal as well as potential functional issues (dry mouth) which can result. Weigh the risks and benefits to help determine if this additional procedure is beneficial in this case for you.
while there are facelift surgeons who do this, i think it's safe to say that the majority of plastic surgeons would avoid this practice because the risks outweigh the potential benfits of doing so.
Removing the submaxillary glands can be a risky procedure, from a surgical standpoint. There are various nerves and blood vessels that are in the way of the surgeon's path to the glands. Removal is routinely done for cancer in the form of a "modified radical neck" procedure, but even those of us who have performed those surgeries are reluctant to perform them for cosmetic purposes.
Also, since the glands provide moisture to the mouth, a "dry mouth" can occur. If a patient has a "marginally dry mouth" removal of some of the gland tissue can cause the dryness to become symptomatic. Most patients, when they discover that this is a potential problem, opt out of the procedure.
From my standpoint, removal of the glands is a "last" option. I prefer to try a suspension procedure involving a web of suture as a first attempt.
A partial removal of a bulging salivary gland under the jawline, the submandibular gland, is an option that can be performed with a facelift in the appropriate patient to improve the contour of the neck. Although there are some excellent plastic surgeons who do this on a regular basis, most well trained experienced plastic surgeons feel that the cosmetic benefits of this procedure are well out weighed by the potential complications and would rarely if ever remove any portion of this gland in conjunction with a facelift.
Robert Singer, MD FACS
La Jolla, California
As an otolaryngologist and facial plastic surgeon, I have a great respect for the salivary glands of the face and neck. It sounds like the surgeon wants to remove or partially remove some of your submaxillary gland. Personally, I do not do this. Some surgeons, however, do it very regularly and quite successfully. The risks include nerve injury to your tongue, depressed scar and drainage of saliva through the skin.
Some patients have very prominent submandibular glands, or glands that have dropped down and are more visible. They are often not seen in the fatty, sagging neck, but once the neck lift is done you may notice them more. There are some surgeons who can remove parts of the gland to make it less apparent. This is not an easy procedure. If you have very prominent glands you should look for a surgeon who has done this regularly in the past. If I can feel a large gland pre-op I let the patient know that they may see it more post-op.
If large submandibular glands are present a portion of them can be removed to improve the jawline as part of the facelift operation. However, I rarely do this because there are increased risks with this technique.
Partial gland removal is a technique used in facelift surgery if the gland is determined to contribute to jowling or contour fullness in the neck. I am not a fan of this because there are a couple of critical nerves and blood vessels in the area. I believe the risks out weigh the benefits.
Earl Stephenson, Jr, MD, DDS, FACS
In some patients with sagging of the face and neck skin in whom a face and neck lift is done, there is ptosis or sagging of the submandibular gland below the jawline of the face. Some Plastic Surgeons Simply Pexy or Tighten This Gland by Suturing It into a Deeper Position. However Many Facelift and Neck Lift Surgeons Choose to Resect and Remove the Gland or Parts of the Gland.
Removing a portion of the (sub-mandibular) gland is not common but not uncommon in facelifting surgery. Removing a portion of the gland, in a certain population of patients, can provide a much better contour of the neck and jawline.
The procedure should be performed by only the most experienced facelift surgeons who have had extensive head and neck surgical training, and only performed in an accredited surgery center.
I have found the partial removal of the glands has helped my patients tremendously when the procedure was indicated.
I hope this helps.