Is resecting the submandibular glands appropriate for my face/neck lift? (photos)

Contouring or partial removal of the submandibular glands is a procedure that is performed selectively by some plastic surgeons to improve the contour of the neck. The vast majority of plastic surgeons can achieve a good cosmetic result without operating on the submandibular glands and will not do that procedure because of the technical difficulty of the surgery and a significant complication rate.I would suggest that your plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the
American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and
are comfortable with. You should discuss your concerns with
that surgeon in person. If you are unconfortable about the proposed recommendations get a second opinion.



Robert Singer, MD FACS

La Jolla, California

Large submandibular glands poses a
challenge post face and neck lift. It can protrude and cause irregular shape
under the jawlines. In the past surgeons removed part of this gland to reduce
the size of it. Injection of Botox can reduce the size of these glands after
facelift surgery.

I concur
with my colleagues; I do not recommend submandibular resection since dry mouths a bad problem to have.

Dear Tucson Friend;It seems that the submandibular
salivary glands are probably located a little lower in your neck. Ideally, if they are just under the edge of
the mandible, they are not visible. When
you have a face and necklift -- and it looks like you’re certainly a good
candidate because your skin looks good and elastic -- there will be a lot
of fat removed and most likely some tightening of the platysma
muscle. It may be that the submandibular salivary glands may be
more visible. Right now, they are
somewhat hidden by layers of fat under the skin.The surgeon’s examination can give a good
clue if that is likely. And it sounds like that may have been the
case at your consultation.Frankly, I have never been keen on
doing that because it adds a lot of complexity to the operation.  The best
procedures are those that have the least complexity. I cannot make a definite recommendation
without seeing you, but I would say my experience over the  years has been -- having operated on
many patients with what appears to be a similar anatomical unacceptability of
the neck-- that yes, sometimes the salivary glands are
a little visible, but the overall improvement is so great that after a while
that imperfection is overlooked.You have to look at cosmetic surgery as
an attempt to improve, but not necessarily create perfection. If the anatomy is very complicated and
unusual, it is not likely one can get a “perfect” result, but you are looking
for substantial improvement. Also,you want a
natural look, not a pulled and overtightened look. Frankly,
removal of the submandibular salivary glands could possibly leave you with a
slight depression. If I were you, I’d have some
more consultations. I think you need to
hear from other surgeons. The question to ask: Is it possible
to have a reasonable result without removing the submandibular salivary glands?
It’s time to do some good
homework, too. Look online at some photos on other
websites, read good books, and have consultations with those surgeons who focus
on the operation you need. I need
not tell you that today the key to success in cosmetic surgery, as well as so
many things in the world, is a high degree of specialization with a long track
of experience. That's what most people
want today .The internet allows
people to search out and find those surgeons who are at the top of the totem
pole in terms of their narrow focus on just a few procedures. You’re always best served by that. Best wishes and good luck. Robert Kotler, MD, FACS