Facelift Question. Is it normal to have part of my glands under my jawline removed?

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.

Submandibular glands are salivary glands that lie on either side of the neck, just under the mandible. As we age, these glands can become more prominent, and sometimes are made more obvious by facelift (necklift) surgery. While some physicians decide to resect part of these glands, the risk of injuring a branch of the facial nerve that innervates the corner of the mouth is increased. For this reason, many surgeons feel it is better to have a little bump than to risk permanent nerve damage. Another option for large glands may be to inject Botox into the gland to shrink it.

Thank you for your question.In some patients, the submandibular gland is quite large and can contribute to abnormal contours in the neck near the jawline.  In these patients, some surgeons will recommend removing a portion of the gland to create a more refined contour.  In experienced hands, this can be done safely.  Patients may have a dry mouth for a couple of weeks, but this almost always goes away.Best,Dr. Michael EpsteinMAE Plastic SurgeryNorthbrook, IL

Hi BlufftongalThank you for your question. It will certainly help others who are concerned about this procedure. This is a recognised procedure but has a high risk of complications and if successfully performed by surgeons who have experience in this kind of surgery. it creates a more defined neck and jaw line, but for most this is an overkill as you can achieve a very good result without having to resect any glands.Be sure to ask and see whether it is actually you want or whether it's the surgeon who wants to perform this to increase his numbers of these cases.Ask your surgeon to put you in touch with other patients of his who have had this procedure and find out how satisfied they were and if they had any complications.

In cases of a very large and/or low lying gland, a portion or the entire submandibular gland can be removed in order to improve neck contour as part of a facelift or neck lift. However, this is not a routinely perfomed procedure anymore due to the associated risks (such as nerve injury and salivary leak). It is important to speak with your surgeon regarding the risks and benefits associated with this component of the surgery. 

Submandibular glands are playing a major role in producingsaliva for oral hygiene and food digestion. Removing these glands can be arisky and compromise salivary function. Older plastic surgeons commonlyremove parts of these large glands to achieve a more angular jawlines. I haveperformed well over 2500 facelifts and occasionally there are patients withlarger submandibular glands that protrude post operatively. To reduce the sizeof these glands I have injected Botox into the glands and there have beensignificant reduction in their size.

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!RegardsDr Guy Watts

The
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.

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.