Is it safe to remove salivary gland? (Photo)

Question

I had a lower face lift to remove jowels and loose skin. Now I have an egg-sized lump under my jaw and still have loose skin. My plastic surgeon said the lump is my salivary gland and I can have it removed but I would have dry mouth. Should I go to a different doctor and have the procedure redone to remove the excess skin? Is there a way to get rid of this lump without removing my salivary gland? Please Help!!!!

Christopher T. Maloney Jr., MD · Answer

Thank you for your question and for attaching a photo. In my opinion you should see an ENT surgeon to look at your salivary glands. They appear much larger than we normally see and if you were my patient, I would suggest and ENT work up before a face lift procedure. To answer your question, it is safe and it is common for plastic surgeons to remove the SMGs at the time of a face lift if the patient has large glands. It takes a little longer and the risk is slightly increased, but in the right patient it is a great procedure. I would have a consultation with an ENT specialist and then make a decision from there. Best of luck.

Brian K. Machida, MD, FACS · Answer

There are alternatives to complete removal for facelift patients, but your glands look fairly large, and it appears that other alternatives might not be enough. It is not simply a matter of taking out more skin. Contrary to other opinions, it is not common to completely remove salivary glands during a facelift. There are actually several nerves at risk without proper exposure of the field deeply and a facelift approach does not give adequate exposure, especially in your case where the glands are fairly far anterior. You only option would be removal via incisions directly over the glands separate from your facelift incisions.

William Marshall Guy, MD · Answer

Hello mooblen,The salivary glands in the neck are called the submandibular glands.  Usually they are just inside of the jaw bone.  In some patients with age they can descend and end up lower down in the neck.  This is not usually noticed unless there is a lifting procedure because the hanging skin that was concealing them is no longer present.  It is best to recognize this before a lift so the patient is aware as to what to expect.  To answer your question, removal of the salivary glands can be performed, but it is not without risk.  There is a nerve that runs just over the gland that helps to control your smile.  If that is damaged, which is a risk, it will change the appearance of your smile on the affected side (think a Sylvester Stallone type smile).  As far as dry mouth it would decrease saliva production by removing them.  There are two other larger ones on the cheeks so if you don't already have dry mouth, it probably wouldn't be noticed.  However, dry mouth does increase with age so electively removing the glands for cosmetic purposes may cause worsening dry mouth down the road.  Also, since the skin has already been redraped and the excess removed, the ability to access those glands through your previous facelift incisions is reduced.  Therefore, to remove them a separate incision on that part of the neck would likely be required.  I hope this helps and good luck.

Is it safe to remove salivary gland? (Photo)

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