Is there anything that can be done about salivary glands that show after a neck lift?

Prominent submandibular salivary glands are something that should usually be assessed before surgery is performed. With the knowledge that these glands may be a problem before surgery, your surgeon can address them during the operative process by suspending them with sutures or occasionally resecting or cutting them. Unfortunately, cutting into these glands isn't always the best idea because you can occasionally have issues with salivation afterwards, and the anatomy surrounding them is complex with respect to the nerves.There have recently been reports showing that botulinum toxin can decrease the size of salivary glands, specifically the parotid gland, this can also be used in the submandibular gland. This may be a good option for you considering that you have already undergone surgery, so talk to your surgeon and see if they have any experience with this.if you need more help, seek out a dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these core four 

Drooping salivary glands under the neck (known as submandibular glands) are one of the most frustrating situations facing facelift surgeons. Since a small branch of the facial nerve travels on top of this gland, I don't usually recommend removal of the gland due to the risks associated with it. There are situations where sutures can be used with caution to lessen its prominence, but overall with minimal change.

The diagnosis of protruding salivary glands should, ideally, be diagnosed prior to performing a neck lift and discussed with the patient.  I routinely discuss this with my patients and if desired the gland is partially removed to provide a better neck contour.  The procedure is safe and does not prolong the recovery period when performed by experienced facial plastic or plastic surgeons.  I noticed after surgery, the prominence must first be accurately diagnosed as the (submandibular) gland and not something else (digastric muscle, seroma, etc).  It is not uncommon for the gland to be swollen after a neck lift surgery and the swelling can take 1-3 months to fully resolve.Botox may have some utility in "shrinking" the gland but should only be performed by experienced Botox injectors familiar with the anatomy.  I hope this helps. 

I think I would start off by asking you to make sure that it is in fact your submandibular glands (salivary glands) that are the problem. Sometimes extra fat that wasn't removed can look and even feel this way. If it is, options are limited from a cosmetic perspective. The problem with these glands is that there are crucial nerves around them. The Hypoglossal nerve, which controls the movement of your tongue, the Lingual nerve which carries taste and touch from your tongue and a nerve called the marginal mandibular nerve which allows you to move the corner of your mouth. If these are damaged there can be unfortunate complications. Here in Ottawa at my practice I remove submandibular glands for non-cosmetic reasons and it is a surgery that requires skill and knowledge. I would not recommend a cosmetic removal to my patients. Other options include using fillers to try to mask the angles and perhaps blunt the shadowing effect. Using Botox is possible, however the risk is potential temporary paralysis of facial muscles. Also, i can affect swallowing if not done perfectly in this area. Sorry for your trouble with this, but I'd recommend seeing a physician in person to really see what the best options are. James P Bonaparte, MD, MSc, FRCSCOttawa, CanadaOtolaryngology - Head and Neck SurgeryFacial Plastic and Reconstructive Surgery

Thank you for your question. This is indeed a very difficult problem to treat. It's difficult to give you advice without examining you or at least seeing some photographs.Nevertheless, I can share with you my thoughts on prominent submandibular glands and neck lift. First of all, depending how saggy the glands are, a platysmaplasty may be all is needed if the gland is only mildly prominent. However, sometimes that is not enough and you will still have some fullness. Other options include suspend the gland (with sutures) or excise (partially or completely). Suture suspension can work if combined with an extended platysmaplasty to improve moderate sagginess. For severe sagginess, only excision will improve fullness. Excision (partial or complete) comes with it's own set of risks and should not be taken lightly, but it is an option.I would encourage you to discuss this further with your surgeon. Good luck!

While most surgeons do not directly treat these glands, I believe it is necessary to treat them in the vast majority of patients. They are difficult to treat, time-consuming, and require complete familiarity with the anatomy of the deep neck. Despite all of these caveats, debunking them is critical to avoid problems such as yours. In my experience, partial resection is the only treatment that works - but it works amazingly well. 

Let's assume platysma muscle tightened, protruding glands can still be visible and leave an bulge.  They can be removed but this is not a very popular procedure partly because there are relatively few surgeons who perform this for cosmetic reasons and it carries more complications.

Ihatemyneck, doing an SMG (submandibular gland shave) and a good platysmaplasty helps this problem considerably. Many patients with SMG ptosis (low  glands) also have a small chin and will benefit from a chin implant. As with all cases make sure you find an experienced facial plastic specialist who has actually performed this procedure before as the anatomy is a bit tricky since the marginal mandibular nerve is close to this structure. Good luck!

Thank you for your question and herniated or enlarged submandibular glands can create a problem with a neck lift.  Partial removal of the gland or correction of the herniation can be performed though.Dr Corbin

Follow up with your
surgeon and review your before and after photos. Often times both the surgeon
and patient forget what the neck and jowls looked like preoperatively. This
will provide some objective information upon which results are assessed. Neck
laxity can certainly mask low lying or “ptotic” submandibular glands. The
glands if they show, will appear as a bulge under the jaw in the neck. However,
it is difficult to predict who will have “bulging” glands that show
post-operatively. If you are still unhappy with your surgeon’s explanation then
a second opinion may help with your dilemma.