Is there a risk of looking worse after a facelift without addressing the submandibular gland problem?

The short answer is no, not addressing the glands will not result in a worse appearance post op.  You can see by reviewing many post op face and neck lifts results online which are wonderful and the submandibular glands are rarely addressed. That being said, if you do have heavy glands, they can be addressed and you should find a surgeon who is comfortable to do this, if you decide that this is something that would bother you post operatively. 

Great question... I have been doing facelift surgeries for over 20 years and do not typically remove glands. I will point out to the patients however who have prominent glands that *sometimes* you are able to see the glands more after the excess skin and fat is removed. Glands are normal. I would make sure you are aware of what they would look like if you do not have them removed so you will be happy. 

Thanks for your question. It is rarely necessary to do a submandibular gland excision with a face lift procedure. There are techniques to tuck in prominent glands using the platysma muscle, while doing a facelift procedure, to reduce the prominence of the gland. You will need an actual physical examination to evaluate the problem and possible solutions.
Please find an experienced Board Certified plastic surgeon who can examine you and help you with all your concerns. All the best!

Submandibular glands are present in everyone, however, in only a few, this gland becomes too obvious and can be observed after a necklift or even before a necklift. There are techniques that surgeons sometimes use to reduce the appearance of the gland either by partially or totally removing it.

Thank you for the question. Without photos and a physical examination, I can't say for sure what the issue is with your glands in particular. For most patients, the glands descend from a position under the lower border of the mandible (jaw bone) to a position in the upper neck where they are more visible (as a lump or fullness). In my practice, I use a technique to tighten the platysma mucle under the glands like a sling or a hammock. This is sufficient for the great majority of patients. If the glands are very large, they can be carefully reduced. However, this adds risk to the nerve that controls the movement of the corner of the mouth. For many patients, knowing this risk, they choose not to have the glands operated. Best of luck moving forward!

Submandibular glands may be normal sized or they may enlarged.  On examination prior to surgery your surgeon should be able to tell whether your glands are enlarged and demonstrate to you by tightening and lifting your skin whether the gland becomes more visible when your skin is tightened. If your gland is not enlarged, a facelift should improve the appearance of your face and neck. If your gland is very enlarged, and is more visible when your tissues are lifted, you would need to discuss with your surgeon  if a portion of it could be removed, what the risks and benefits of that are and make a decision about whether this is what you want to pursue.  Removal of the submandibular gland is not commonly done with a facelift but it is within the realm of what some surgeons do. You would need to find a surgeon who has extensive experience in this should you wish this done.  Best wishes.

Hello and thank you for your question. Majority of the facelift patients have good results without submandibular gland excision, which is typically not a component  of a standard facelift. Tightening the platysma muscle, which overlies the gland, is typically enough to give most patients a nice jawline/neck contour. I would seek consultation with a board-certified plastic surgeon for a full evaluation and advice. In particular, ask your surgeon to show you before and after pictures of his/her patients. Your surgeon should be able to show your numerous examples of their work. Best,
Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon

Thank you for your excellent question. Without a physical exam it is impossible to determine if the submandibular glands should be removed at the time of the face lift. In my practice of about 130 face lifts a year, I would say I remove the SMGs in less than 5%. This is because the majority of people do not require the removal to have an excellent face lift result. There are some patients with prominent SMGs that removal is necessary for the best result. You need to find an experienced board certified plastic surgeon in your area who in an ASAPS member and who specializes in facial rejuvenation. Best of luck.

Submandibular removal is an advanced technique which should only be performed by experienced facelift surgeons. The submandibular gland is one of several large salivary glands. As we age, in many people it will tend to enlarge, creating a noticeable bulge in the neck. Efforts to simply lift the gland or tighten the platysma over top of the gland do not work well. Partial removal of the gland is performed in order to get the smoothest neck possible. It does have some increased risks, most notably bleeding, but this is a very uncommon complication, though possibly having devastating consequences. I perform partial submandibular gland regularly but selectively and discuss the pros and cons with my patients during their consultation. 

Hi.  I think you would have a very low chance of looking worse after the facelift, if the facelift is otherwise done well, but without resecting the submandibular glands.  There may be some benefits in resecting the glands or partial resection, but you also have to weigh that against the much more invasive nature of doing that procedure and the risk of postoperative bleeding and what that entails.  Personally, I do not choose to offer my patients resection of the submandibular glands for those reasons, but other patients and surgeons choose to do that and that is also reasonable as long as someone is very well informed about it.  I would recommend consulting with a board certified surgeon, either plastic surgery or facial plastic surgery, who has very good experience in this area to help you navigate through the process.  Good luck and take care, Dr. Howell