Can the potential for issues with the submandibular glands appearing prominent, be recognized prior to or during a neck lift?

I am 55 and 6 mos post op lower face/neck lift with removal of a 20 yr old chin implant, which had formed a shelf-like encapsulated growth on top of it. I also have a long slender neck, which has lead to the significant appearance of my submanibular glands. Had my PS recognized the potential for this, what could he have done differently during surgery? Can I expect any changes at 6mos good or bad? Are there any non-surgical aids/fixes besides Botox? What about Kybella or laser treatments?

Doctor Answers 4

Facelift/Neck lift and the submandibular glands

Facelift/Neck lift is a surgery to improve the contours of your neck. This may be achieved with a number of techniques. 

Submandibular glands are salivary glands that are under the jaw. They can be large or hang low. Often they are obscured by loose skin or neck fat.

Tightening in a skinny person or submental liposuction can unveil these glands. They can be palpated before surgery; however it is still a difficult judgement call regarding how prominent they will be after the procedure. Your surgeon may discussion options that may include less aggressive liposuction or a procedure to reduce the glands at the same time as your lifting procedure. 

As you heal and tissue relax, your glands may become less visible. It will be a slow improvement. It is not advised to use Kybella. After a year, if you are still not pleased with the result, the glands may be reduced surgically. It's not a procedure that every surgeon performs, so I would ask around. Safety comes first. 

San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Hard to Predict--Botox for Submandibular Glands

This would have been difficult for him to predict prior to your procedure. Botox works very well for this condition and as well to help the neck skin.  I suggest an inperson consultation to know if you are a candidate.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Submandibular glands

It is not an easy problem. When there is fat under the skin before surgery, it may not be easy to know that your gland ( it is usually only an issue on one side) is low. 

In surgery when you are lying on your back, the surgeon vacuums the fat away, but it is not possible to see that the gland is low because of gravity and your position. The best treatment is botox.


Richard Sadove, MD
Gainesville Plastic Surgeon
4.8 out of 5 stars 18 reviews

Submandibular glands noticeable post surgery

This question has yielded debate topics and numerous panels at just about every plastic and facial plastic surgery meeting over the last couple years! Addressing the submandibular glands is all about recognizing ptotic submandibular glands before surgery - sometimes, depending on what your neck was like before surgery, this can be very, very difficult.  While not ideal, in some patients we discover the ptosis intraoperatively.  There are differing schools of thought on this, and you will hear different surgeons preach that either plicating the muscle to create a sling/partial excision/total excision/cautery and gland ablation/ doing nothing are the "right" way of treating the problem.  To be honest with you, like I just mentioned, it is a little more complicated than that as there can be serious complications associated with either of these procedures.  I'd love to discuss more about it, but it would make for a very, VERY long answer.  

As far as expecting changes, you certainly can.  Your body will continue to heal and settle over the next 6 months - usually at a year you can expect to stop seeing changes.  Will these changes be dramatic over the next 6 months? No, they will not.  However, they will be subtle and you may continue to improve.  As far as non-surgical fixes, different docs have had different success with different techniques - depending on what was done during the surgery. Kybella is an absolute no no in the submandibular glands.  I strongly suggest you speak to your operating surgeon about your concerns.  I hope I helped answer some of your question! Best of luck.  

Miguel Mascaro, MD
Delray Beach Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.