Is There a Specialist Who Can Correct Visible Salivary Glands Post Facelift?

Salivary glands can descent with age in some patients; others are predisposed to the problem because they have a small chin or jaw 'pushing' the glands downward.  Tightening the platysma muscle at the time of facelift can sometimes help with this but not always.  If you have had the facelift already, trying Botox in the glands to shrink them slightly can help.  Botox will not make them go over but can be a nonsurgical option that you can explore if you would be happy with an improvement.  

At my practice in Los Angeles, I work closely with salivary gland specialist Babak Larian, MD, FACS, and we often perform cosmetic and reconstructive procedures together to bring our patients optimal results. As a board certified facial plastic surgeon, it seems that what you are describing can be corrected through revision facelift surgery with specific attention focused near the submandibular glands. You could be suffering from ptosis of the submandibular glands, which can be corrected through muscle and skin tightening.

 

You likely have submandibular gland ptosis. It was likely present before but was camouflaged by the excess and loose skin. There are potential solutions. pexy of the gland or excision of the external 1/3 to 1/2 can be done via a submental incision. I’m in Austin, where are you?

assuming nothing else in your facelift required attention, it would not take very long 1 -2 hrs max

 

According to your description you are referring to submandibular glands. These glands can be reduced in size  during the neck lift part of the procedure. A physical examination is a requisite before determining the most appropriate course of action. 

The submandibular salivary glands commonly enlarge and descend with age. When the more-noticeable aging changes of loose/excess fat, muscle, and skin are addressed in a neck lift, these glands are sometimes unmasked. Critical nerves exist immediately "over" and "under" these glands, so they are often not addressed with face/neck lifting surgery.A few expert neck lift surgeons are comfortable safely treating these glands. Seek one out.In my experience, when I return to a neck to remove such glands, patient satisfaction is high.

Dear Miz,

Thank you for your question.  These glands you speak of are either imbricated pushing them higher under neath the jaw, partially removed or completely removed.   It depends on your tissue laxity and visibiltiy. Discuss this with your plastic surgeon.

Best wishes,

Pablo Prichard, MD

While your neck, as described, is the most common type of anatomy to show the salivary glands after a neck lift, it is still rather rare but should be discussed as a possible problem postop. With that said, most Plastic Surgeons are adept at treating the problem and I see no reason to travel for a repair. Generally speaking, the glands could be  elevated and sutured in place with tightening of the platsyma muscle or the glands could be partially resected. And no, a facelift cannot truly be reversed.

My suggestion, since you are obviously distressed about the problem is to see a plastic surgeon in your area.  There are many fine plastic surgeons in Dallas and Houston associated with the university medical systems that should be able to help you.  This is not an unusual condition but it is difficult to assess your problem with our pre and post op photos. 

Dear Mizwillabean,

Prominent submandibular glands are a common cause of bulging in the neck. Removing part of the glands and/or tightening the surrounding tissues during a necklift can soften the bulges. A necklift requires significant skill, experience, and finesse.

Please see an experienced, Board Certified Plastic Surgeon or Facial Plastic Surgery for an evaluation.

Warmest wishes,

Larry Fan, MD

Ptosis of the submandibular glands isn't that uncommon in patients with a weak chin and/or a tall slender neck with little subcutaneous fat. A good platysmaplasty with a chin implant (if needed) can at times improve this but not always. I've performed an SMG shave on quite a few patients over the last 12 years since first exploring this technique and have written about the approach in a book published by Thieme entitled "Neck Rejuvenation" published in 2011, chapter 10 if you can find a copy of the text book. The problem with any manipulation of the SMG is that it puts the marginal mandibular nerve at risk and should this nerve be injured due to stretching or otherwise the patients mouth will move abnormally due to weakness of the depressor anguli oris muscle. I've never had this complication but I stress to any patient considering manipulation of this gland that that is a possibility. So yes something can be done but do your homework. Good luck!