Salivary glands and facelift?

Question

I am considering a facelift but my concern is the salivary glands and how they will be addressed in this procedure. I am slim and I can see and feel the submandibular salivary glands so it concerns me that with a tighter jaw/neck line they will be much more apparent. What is done during surgery to avoid this problem? I know I am not Robinson Crusoe here.

Howard Webster, MBBS (Hons), FRACS · Answer

Hi there, I've enjoyed reading this thread and your question because of the variety of opinions I knew it would bring.My comments are a little different.I completely agree with you. The submandibular glands, if visible preoperatively, as an issue.  They're always visible post op if visible preop and sometimes they are even more visible. In this event they detract from the neck result.I don't believe the suspension techniques work well. The best way by far to eliminate the gland visibility is a subtotal resection which works well and looks good. It doesn't seem to cause a dry mouth, there are other salivary glands, although medically you should have no history of connective tissue disease if considering this.Why don't plastic surgeons take the gland out or operate on it very much?  Because it's hard and a little scary, that's why, and many surgeons are frightened of it.  Access can be difficult - the approach is a small incision under your chin. It can bleed - the large facial artery runs over it, and the facial vein under it- and there are relevant nerves in the area.  So the truth is that many plastic surgeons if not most, will just not ever operate to take out the gland - and they'll have various reasons they'll tell you for choosing not to do this.I don't much like taking the glands out. I've learnt that when I need to, to allow adequate operative time for it.  I allow an extra hour - and when planning it, to see it as the most important part of the procedure, not as a little adjunct to the necklift component. I do resect the gland from time to time, and if done with time and care, it's not too bad. But I don't do it all that often.In Melbourne, the surgeon with the most experience in gland resection by far is Bryan Mendelson.I hope this helps,All the bestHoward WebsterPlastic Surgeon.

Mark Karolak, DO, FAOCO · Answer

Enlarged submandibular glands can cause fullness in the neck. This fullness is present before surgery, but it may be a concern for patients afterwards because everything else looks so good. I have found that when patients are made aware of it before surgery as well as risks associated with removing them, it tends to be a non issue afterwards. These can be removed during the surgery, but would add significant risk to the nerve that controls movement of the lips as well as increase the risk of significant bleeding during surgery. Other types of treatments like suspension procedures may be helpful.

Damien Grinsell, MBBS, FRACS (Plast) · Answer

Hi.Excellent question and there are 2 camps of plastic surgeons on this topic.  The first believe that by tightening the platysma it will help suspend the glands and make them slightly less prominent.  The second take a more aggressive approach and remove either part or all of the gland in order to sharpen and improve the jawline profile.  This approach has a higer complication rate including nerve damage and bleeding.  In short you need an opinion from an Australian qualified plastic surgeon who can determine how much of a problem it is and counsel you appropriately.RegardsDamien

Fernando Colon, MD · Answer

This is a good question. Many patients may havenoticeable submandibular glands preoperatively.It is important for the plastic surgeon and patientto discuss it and consider the approach. In generalgood preoperative planing and avoidance of makingthe neck soft tissues to thin works for most patients.Operations directed twards the glands themselvesare rarely required.Best wishes

Vincent N. Zubowicz, MD · Answer

Palpable submandibular glands seldom create contour problem of the neck after facelift provided the platysma muscle is properly dealt with. Rarely a pathologically large submandibular gland might require removal for the best result in the neck.

Salivary glands and facelift?

Answers (8)

Answer: Submental salivary gland and face lifts.

Answer: Submental salivary gland and face lifts.

Answer: Removal of submandibular glands as part of a facelift is seldom indicated.

Answer: Removal of submandibular glands as part of a facelift is seldom indicated.

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Everything you need to know about Facelift

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Salivary glands and facelift?

Answers (8)

Answer: Submental salivary gland and face lifts.

Answer: Submental salivary gland and face lifts.

Answer: Removal of submandibular glands as part of a facelift is seldom indicated.

Answer: Removal of submandibular glands as part of a facelift is seldom indicated.

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Everything you need to know about Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.