Swelling and Red Lines After Multiple Procedures

I had Facelift,Cheek Lift, Lip Lift, Blepharoplasty, and Rhinoplasty 5 months ago. Have normal numbness around ears and jawbone. Happy with results except right salivary gland very swollen and slight red line along jawbone. Very visible from right side profile, left gland not swollen. Doctor said nothing to do but remove it and he didn't recommend it. Said visible because he pulled platysma muscle back. Said it was like this before, but I know my body pretty well and it wasn't. Just in case it's relevant, nose runs all the time since surgery. Using cortisone on incisions, fluticasone propionate for nose. Any recommendations?

Doctor Answers 9

Botox may work for swollen gland

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The mechanism of action of Botox, blocking the release of the same neurotransmitter that stimulates gland secretion, can make Botox (or now Dysport) an option for treating swollen parotid glands. You should ask your doctor to consider this treatment if the swelling persists.

San Francisco Facial Plastic Surgeon
4.3 out of 5 stars 14 reviews

Gland removal is not recommended

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The swelling in the neck is from the submaxillary gland and is a very difficult problem to address if it is at the time of a facelift. By removing the gland, this can make the mouth dry, which can lead to cavities, and so it is not recommended to do so. There is also inflammation, infections in that gland, and tumors that can cause it to enlarge, and these have to be addressed by your physician.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

You need to see a facelft specialist.

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 The swelling needs to be investigated now. Get another opinion from a facelift specialist. You need to know if you have an infection, a saliva fistula, etc. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Post Operative Healing

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Dear Young at Heart,

You have multiple symptoms which are a little long after your procedures.  Return to your Doctor for a follow up exam and possible investigations.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews

Prominent Salivary gland after Rhytidectomy

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Submandibular glands that were not or barely visible before surgery may become more visible after the skin is tightened. Some surgeons advise removal of the gland or partial reduction but this can add additional complexity and risk to the procedure

Think about a baseball under your bed sheets. If they are loose and messy, you may miss the lump but if you suddenly pull the sheets taut, you may be more aware of the baseball lying under the sheets.

The red line puzzles me. It could be a tension line, lymphangitis, or some other cause that is inflammatory or infectious in nature. This I don't understand and you should seek an explanation for this.

Another possibility is sudden inflammation of the salivary gland called sialoadenitis. This couls explain it all buit is very unusual.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

A swollen, red salivary gland could be infected

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Dear Young at Heart,

Is the gland painful? Does it hurt or get larger when you eat food? Is there a foul taste from under your tongue? How long after the surgery did you notice this?

The redness, and asymmetry could mean infection that would clear with a course of appropriate antibiotics.

Runny nose after rhinoplasty is common. I've found that topical antihistamine sprays (Patanase) works better than steroid sprays like fluticasone.

I hope this is helpful, and best of luck to you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

You need another opinion with a board certified plastic surgeon.

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Hi You definitely need another opinion.

1) The swelling under your right jawline is much too big to just be a more noticeable salivary gland after a facelift.

2) A continually runny nose after a rhinoplasty can be a serious symptom.

In Manhattan, I would investigate these two problems promptly. See link below for a name near you.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Second opinion

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Your surgeon could very well be correct. It could be a prolapsed gland that becomes more evident as the loose tissue surrounding is tightened. I am not sure I understand about the red line. In any case, it sounds as if your surgeon is reputable and did a good job with all of your procedures. If you are unsure, you can always seek a second opinion or even ask your surgeon for a second opinion referral to confirm or refute his diagnosis. Remember that cosmetic surgery can be a big improvement but not always is it perfect.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Salivary Gland Swelling after Facelift

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There are 2 pairs of salivary glands that could be involved with a facelift: parotid gland (in front of ear and around earlobe) and submandibular gland (below jawbone within neck). Most likely, you are referring to the submandibular gland. It is true that this gland can become more noticable after a face and neck lift after the camouflage of excess skin and loose muscle has been removed. The gland can be asymmetrical - I would study your before photos to search if this was there before. Although some surgeons remove the gland (or part of it) as part of a necklift, personally, I do not advocate this.

There is probably no relationship to your runny nose. There are many other reasons why a salivary gland can be enlarged and you should investigate this further. Sometimes, a CT scan or MRI scan can provide information in addition to a good physical examination.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 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.