I am going to have a face and neck lift soon and was told I had large submandiblar glands. Could this be a problem?

Doctor Answers 21

Large Submandibular Glands Sometimes a Problem

The delineation of a youthful jawline and neck is an important part of face lift surgery because it plays an important role in the perception of youth and beauty.

Submandibular glands that are large or hanging can contribute to fullness in the upper neck and can become more noticeable after surgery as the overlying skin is tightened and surrounding fat is removed. The good news is that most glands do not need to be surgically removed. Instead they can be effectively treated by suspending the platysma muscle or by using suspension sutures to elevate the glands.

There is a much smaller subset  of individuals that would benefit from partial gland resection in order
to achieve the most optimal aesthetic results. The submandibular gland can be partially excised through a small incision under the chin by a surgeon that is familiar and comfortable with the anatomy of the submental triangle. 

I suggest that you return to your surgeon prior to your face lift operation to make certain all of your questions have been answered. Ask your doctor to point out the size and position of your submandibular glands and to outline any plans for treatment. What is the expected outcome? It is possible that your surgeon expects a pleasing outcome but wants to frame your expectations in the context of larger than average submandibular glands.

Best of luck 

Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 112 reviews

Large submandibular glands can create modest contour abnormality after a facelift.

Large submandibular glands can create a small bump in the neck after a well executed facelift. They can sometimes be supported by implicating the platysma muscle over the gland. Excision of the glands is one alternative but it is rarely indicated.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Are submandibular glands a problem for my face lift

Thank you for your question about your face lift.

If you have a thin face and prominent glands, you may notice them more after your face lift.
  1. At surgery, a suture can be placed to support them so they don't show as much.
  2. If you are bothered by the glands' size afterwards, it is worth trying a small injection of Botox but chances are you will not be bothered by this.
Always see a Board Certified Plastic Surgeon.
Hope this information helps. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

I am going to have a face and neck lift soon and was told I had large submandiblar glands. Could this be a problem?

Large submandibular glands can cause a noticeable lump in the neck after facelift. Be sure to ask your surgeon if he/she can pexy or lift the gland to make them less obvious after surgery.

Large Submandibular Glands Post Facelift Surgery

Large submandibular glands poses a challenge post face and neck lift. It can protrude and cause irregular shape under the jawlines. In the past surgeons removed part of this gland to reduce the size of it. This can cause dry mouth. Injection of Botox can reduce the size of these glands after facelift surgery.

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
4.9 out of 5 stars 204 reviews

Submandibular glands

This wll not pose a problem during your sugery. Your surgeon may have let you know so that if they are more visible after your neck rejuvenation you won't be surprised.

All the Best

Dr. J

A. Dean Jabs MD, PhD
Board Certified Plastic Surgeon
Bethesda, MD/McLean, VA

A. Dean Jabs, MD, PhD, FACS
Bethesda Plastic Surgeon
4.9 out of 5 stars 88 reviews

Treating enlarged submandibular glands is essential

Enlarged submandibular glands often contribute to the contours of the aging neck. In some patients, this enlargement is minor, and can be ignored or dealt with via more straightforward options such as corset platysmaplasty and suspension sutures. 

In other patients, however, partial excision of the glands is 100% necessary to obtain truly youthful and attractive neck contours. In my experience, about half of my facelift patients require partial recession of the glands to obtain the best neck shape their anatomy can support.

Yes, there are important nerves and blood vessels in the area, and partial gland resection is difficult to perform safely. In expert hands, it is very demanding, and adds almost an hour to the neck lift portion of a facelift. Nothing good is easy. 

If you are looking for the best results, find a surgeon who is up to the challenge and routinely incorporates this key step into his necklift practice. 

Laxmeesh Mike Nayak, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 199 reviews

Face and Neck Lift and Large Sub-Mandibular Glands

Dear choclee:

Just as the skin, fat and soft-tissues of the face and neck have relaxed and moved "south" with aging, so have the submandibular glands and the "floor" or suspensory tissues of the mouth. As the tissues "fall", they show themselves below the level of the jawline and so they may appear enlarged. Usually, the submandibular glands, lymph nodes and other tissues simply need to be tucked back into place. A thorough examination is needed to be sure there is no other cause for "enlarged" sub-mandibular glands.  

Options for re-suspension of the submandibular tissues include:
  1. Corset platysmaplasty
  2. Giampapa-style neck suspension
  3. suspension of the submandibular glands
  4. shrinking the submandibular gland with Botox (good trial as to dry mouth effects)
  5. partial or full excision of the submandibular glands (risk of dry mouth and other concerns)
  6. and other more involved procedures.
Please discuss this fully with your Face and Neck Lift Surgeon or consider a second opinion to review your concerns with a well experienced Board Certified Plastic Surgeon or Facial ENT. 

I hope this was helpful. All the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 82 reviews

Dealing with submundibular glands

Sometimes a surgeon may opt to trim the submundibular glands, however most do not because it is associated with risk of salivary fluid collection and drainage.  At our practice we do not touch salivary glands.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 458 reviews

I am going to have a face and neck lift soon and was told I had large submandiblar glands. Could this be a problem?

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

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 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.