Occasionally the sub mandibular glands can be large.. When this is the case These salivary glands are often chronically obstructed. Rarely is indicated to remove them to rejuvenate the neck.
Thank you for the question. The submandibular gland is a salivary gland located below the jaw line in the neck. With ageing this gland can enlarge and protrude contributing to loss of definition of the jaw line and neck. Although removal of part of the submandibular gland can accentuate the jaw line and improve neck definition it would not be considered a common component of a facelift, rather an additional procedure in a select group of patients. It is something that you should discuss in detail with your surgeon and balance out the risks and benefits before proceeding with the surgery.
Best of luck!
Dr Guy Watts
salivary glands are located under your jaw line (termed submandibular and
submaxillary salivary glands), and are usually hidden behind your natural jaw
and soft tissue of your neck. In some people the glands can be lower down and
create bulging in the neck, this can create a more bulbous or irregular shape
and contour of your neck. Most people who undergo facial rejuvenation with face
and neck lift surgery do not require surgery on their salivary glands. In some
people as a consequence of their natural anatomy and facial ageing the position
of the glands could effect the final surgical result. In these patients partial
removal of the salivary glands as part of the face and neck lift surgery may be
beneficial and improve the result of the surgery. The anatomy of the salivary
glands include a very powerful blood supply, hence surgery on the glands needs
to be both cautious and reserved for when necessary to avoid unnecessary issue
from surgery. If your salivary glands are more prominent in your neck, then
partial removal of the salivary glands at the same time as facial rejuvenation
surgery may improve the results of your surgery, an assessment is required to
determine your individual needs and suitability for this surgery.
While this is a recognized procedure it is not routinely done in most facelifts. There are risks relating to this procedure and it should only be performed in situations where the submandibular glands are large, low lying and significantly affecting neck contour. I have performed 100s of facelift procedures and have done this procedure on very few patients over the past 15 years. I dont believe it should be done routinely nor by a surgeon who does not routinely perform head and neck surgery.
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.