Will my submandibular glands be visible after a facelift? How can I tell?

Hi Beholder,

Thank you for your question. You ask a good question, and I recommend that you discuss this with your surgeon. They will be able to assess on exam whether you have prominent submandibular glands when they manually pull back your neck skin. Submandibular gland size varies by individual, and those with larger glands will more likely to have prominent-appearing glands after surgery. While I do not typically remove submandibular glands when I perform facelift procedures, there are facial plastic surgeons and plastic surgeons who do. 

Thank you for your question. This is a really good question! If you have prominent glands, then they might become more obvious after a facial cosmetic procedure. There are some surgeons who reduce the glands but this comes with additional risk and needs to be discussed carefully. Even with a physical exam it can be hard to determine how things are going to look but your best bet is to see an experienced local board certified plastic surgeon for a consultation and ask him or her this very excellent question!Best of luck!

This question is tough to answer without examining you in person, but I love that you are doing your research! When examining you in person, a surgeon can manually lift or retract the tissues in a way to simulate the results one can expect with surgery. If they look unusually prominent, the exam may reveal this. I personally do not reduce the size of the glands during facelifts. Depending on how the facelift is designed (and again one would need to examine you to determine the best option for you), in most patients this is not an issue. There is a huge variety in how facelifts are performed, and the technique is critical to the results. Some techniques offer a more powerful lift and a more long-lasting lift. I would recommend seeing a board certified plastic surgeon for an evaluation and discussion of what would be best for you. For this type of surgery, it is also a good idea to potentially see more than one surgeon to get a sense of the different techniques and choose the one you feel comfortable with. The way I see it, trusting someone to do your facelift means you are forming a relationship with your surgeon, and you want to be confident the surgeon understands your goals, feels she/he can meet or exceed your expectations, and will be there for you throughout the process.

They are suspended below the jaw line and hidden by soft tissue including fat and loose skin.  Tightening the neck can make them more visible.  Resecting or shaving the submandibular gland is a high risk procedure that in my opinion is only warranted in rare situations.  Surgery on the submandibular gland can put the marginal mandibular nerve at risk and can result in very difficult to control blood loss.  Often it is better to simply accept minor visibility of the gland's contour.  Talk with your potential facelift surgeons regarding this concern.

Generally an exam by your operating surgeon can determine if your submandibular (salivary) glands are ptotic or drooping below your mandible (jawbone).   In most cases, the glands don't negatively impact a facelift result.  But if patient's are expecting this fullness to be gone, it is important to note it preoperatively.  There are ways to address drooping glands by pexying or suturing back up under the mandible or removing a portion of the gland.   These approaches do put the smiling nerve (marginal mandibular nerve) at risk and are not widely performed. 

Dear Beholder,
The submandibular glands are the size of a walnut. They tend to drop down as we age. Some are more prominent or swollen than others in people. If you can feel them now under your jaw line, they may become more visible when your neck lift is done.

In general, your submandibular glands will be prominent postop if they are prominent preop. I do not personally believe a facelift makes the glands look more prominent than they did before surgery in most patients. I do not resect the submandibular gland - I think the risk of bleeding, nerve injuries, mouth dryness, etc. simply is not warranted in the average patient. Some surgeons are more aggressive about the gland but it simply is not my preference from a safety standpoint.

Dear Beholder: The short answer is yes, submandibular glands will  be visible after a facelift; they will probably be visible after neck lift as well.Some submandibular and the occasional submental glands are visible since childhood. The (unfortunate) aging and associated laxity of the visible skin occurs to all under-the-skin tissues as well. No, glands are not similar in size per side nor per person. Should they grow or be of particular concern to you, please consult with your Board Certified Plastic Surgeon or Facial / ENT Surgeon for his/her evaluation, recommendations and direction. There is the rare specialist who will remove part or all of the gland but this is fraught with potential complications of bleeding and nerve injury or Botox use may also cause side-effects such as dry mouth, loss of taste and increased risk of dental caries. Many Plastic Surgeons are able to assist in elevating or suspend the glands with the platysma muscle or suture suspension but this too is not guaranteed. I hope this was helpful. All the best!

If your submandibular glands are not prominent and visible before surgery a facelift will not make them more visible. Ask your doctor about whether you have prominent glands.

Ask your surgeon. It is fairly easy to determine by reviewing photos and examining the area beneath your jaw. I do not advocate removing/ reducing the gland but sutures can often times be used to reposition the drooping gland back into its fossa. Best.