Removal of Submandibular Glands in a Deep Neck Lift – Yes or No?

Facial and neck contouring procedures have grown in popularity for those seeking a refined, balanced, and more harmonious appearance. A well-contoured neckline is often associated with youth and vitality, but genetics, weight fluctuations, and ageing can lead to fullness beneath the jawline that may not improve with diet or exercise. In such cases, surgical options may help address these deeper structural concerns.

A deep neck lift is a surgical technique that focuses on reshaping the deeper layers of the neck to improve jawline definition and neck angle. In some instances, this procedure includes the removal of submandibular glands, which are paired salivary glands located under the lower jaw. When these glands are prominent, they may create visible bulges or fullness that cannot be corrected through fat removal or muscle tightening alone.

This blog article will help if you are considering facial or neck contouring surgery, including those looking for more tailored approaches to structural improvement. It is also useful for people preparing for a surgeon consultation about aesthetic neck procedures who want to understand the technical aspects and how gland removal may influence outcomes.

Finally, it is designed to help those seeking to understand more about the potential role of submandibular gland removal in surgical neck reshaping, particularly if they have been advised by a surgeon that gland prominence may affect their overall future result.

It aims to present an educational and balanced overview, avoiding promotional claims and focusing on facts that help support well-informed decision-making.

Submandibular Gland Removal (SGR) in a Deep Neck Lift

Submandibular gland removal is a surgical technique involving the careful excision of one or both of the submandibular salivary glands during a deep neck lift procedure. These glands sit beneath the jawbone and play a vital role in producing saliva that aids in the digestion of food and lubrication of the mouth. While their primary function is medical, in some individuals, their prominence contributes to a rounded or bulky appearance under the jawline.

During a deep neck lift, the surgeon addresses multiple layers of the neck, including fat, muscle, and connective tissue. In cases where the submandibular glands create visible fullness that cannot be addressed by adjusting soft tissue alone, they may be surgically removed to improve the aesthetic outcome. This part of the procedure is not routine and is only undertaken when the gland’s visibility affects the contour of the neck and lower face.

The removal process involves precise dissection and identification of nearby anatomical structures, including nerves and blood vessels. Because the area is complex and sensitive, the technique requires a high level of surgical expertise. It is most commonly performed under general anaesthesia in an accredited facility.

Who Should Consider Submandibular Gland Removal?

Not everyone undergoing a deep neck lift will require or benefit from submandibular gland removal. However, there are certain scenarios where this option may be discussed during a surgical consultation.

People with naturally prominent submandibular glands may notice rounded bulges beneath their jawline. These can be particularly visible in individuals with little facial fat or those who have experienced significant weight loss. When other techniques, such as liposuction or platysma muscle tightening, are insufficient to address this fullness, gland removal may be considered.

Those seeking highly defined angles and sharper transitions between the chin, jawline, and neck may also explore this option. For individuals such as performers, professionals in visual media, or those with aesthetic preferences for high definition in facial features, even small areas of fullness can be distracting. In these cases, removal of the glands may support their desired outcome.

Additionally, patients with asymmetrical gland development or positioning may benefit from selective removal. In some individuals, one gland is more prominent or positioned differently, creating visual imbalance that can affect overall facial harmony. A personalised approach is taken in each case to determine whether removal is appropriate.

Suitability for the procedure depends on your anatomy, general health, medical history, and treatment goals. It is important that patients discuss their motivations and expectations thoroughly with a surgeon to assess whether gland removal offers potential benefits without introducing unnecessary risks.

The Role of Submandibular Glands

The submandibular glands are salivary glands located just below the jawline, and in some individuals, these glands can be more prominent, contributing to a fullness under the jaw. This prominence can be due to natural anatomical variations or changes that occur with age. In some cases, the visibility of these glands may detract from a clean and defined jawline, particularly for individuals who are undergoing neck lift surgery to achieve a sharper contour.

Why Remove Your Submandibular Glands?

The removal or partial reduction of the submandibular glands is sometimes considered during a neck lift to enhance the overall result. It is important to note that this aspect of the procedure is highly individualised, and the decision to remove or reduce the glands will depend on the patient’s unique anatomy, aesthetic goals, and the surgeon’s clinical judgement.

The submandibular glands are responsible for producing saliva, but their removal during a neck lift does not typically affect salivary function significantly. This is because the human body has multiple salivary glands, including the parotid and sublingual glands, which continue to function normally even if the submandibular glands are reduced or removed. The aim of gland removal in the context of a neck lift is to create a smoother, more streamlined jawline, particularly in cases where gland prominence contributes to an undesired fullness or bulge beneath the chin.

The removal of these glands is not suitable for every patient, and careful evaluation by a qualified surgeon is essential. Factors such as the patient’s age, overall health, and specific anatomy are all taken into account to determine whether gland removal would be beneficial.

Who Is a Good Candidate for Gland Removal?

Not all patients undergoing a neck lift will need or benefit from submandibular gland removal. Ideal candidates for this component of the procedure are those who have a noticeable bulge or fullness under the jaw that is caused by prominent glands rather than fat or loose skin. In these cases, gland removal can help achieve a more refined neck contour that aligns with the patient’s aesthetic preferences.

Candidates should also be in good overall health, with no underlying medical conditions that could increase the risk of complications. A positive attitude and realistic expectations are also important, as gland removal will not drastically change one’s appearance but rather provide a subtle enhancement to the jaw and neck area.

Consultation and Planning for Surgery

The consultation process is an essential part of planning a neck lift with gland removal. During the consultation, the surgeon will assess the patient’s facial anatomy, discuss their aesthetic concerns, and determine whether gland removal is appropriate. Advanced imaging techniques may be used to help the surgeon visualise the underlying structures of the neck and plan the surgery accordingly.

The surgeon will also explain the potential risks and benefits of the procedure, as well as what to expect during the recovery process. Patients should feel comfortable asking questions and addressing any concerns they may have during the consultation. Understanding the details of the procedure and having realistic expectations will help ensure a positive surgical experience.

Balancing Aesthetics and Function

One of the key challenges in performing a neck lift with gland removal is balancing aesthetics with function. While the goal of the procedure is to achieve a more defined neck and jawline, it is equally important to ensure that the function of the salivary glands and the surrounding nerves is preserved. This requires a high level of skill and precision on the part of the surgeon.

A conservative approach is often taken when it comes to gland removal. Rather than removing the entire gland, the surgeon may opt for partial reduction, which can provide the desired aesthetic outcome while minimising the risk of complications. The decision will ultimately depend on the patient’s unique anatomy and the extent of gland prominence.

Gland Removal Procedure Overview

Submandibular gland removal (SGR), when combined with a deep neck lift, is performed in a fully equipped surgical facility by a qualified specialist such as a board-certified plastic surgeon, facial plastic surgeon (ENT Surgeon in Australia), or a head and neck specialist. The procedure typically involves general anaesthesia to ensure comfort and optimal control during surgery.

The operation begins with incisions placed under the chin and possibly behind the ears. These incisions allow the surgeon to access deeper layers of the neck and create a concealed path to the gland. Once the platysma muscle is opened and the submandibular gland is located, the surrounding tissues, including critical nerves and blood vessels, are carefully identified and preserved. The gland is then gently dissected and removed.

The removal process can be technically demanding due to the proximity of the marginal mandibular branch of the facial nerve, the facial vein, and the submandibular duct. Surgeons use magnification and delicate instruments to navigate this area safely and with precision.

After the gland is removed, the surrounding tissues are assessed, and the neck contour is reshaped. The platysma may be tightened or re-sutured, and excess skin is repositioned. The incisions are then closed with fine sutures, and a supportive dressing or compression garment is applied to reduce swelling and support healing.

The entire procedure can take several hours, especially when combined with other techniques such as fat removal or jawline contouring. Patients are typically monitored during the initial recovery period and may be discharged the same day or after an overnight stay, depending on individual needs and the scope of the surgery.

Close follow-up care is scheduled to monitor progress, remove sutures if necessary, and provide ongoing guidance during the healing phase.

Combining Neck Lift with Other Procedures

In some cases, a neck lift with gland removal can be combined with other facial procedures to achieve a more comprehensive rejuvenation. For example, a facelift can be performed alongside a neck lift to address both the lower face and neck areas, creating a more cohesive and balanced result. Additionally, procedures such as chin augmentation or liposuction can be considered to further enhance the contours of the jawline and neck.

Combining procedures can be advantageous as it allows for a more harmonious overall improvement, and patients can benefit from a single recovery period rather than undergoing multiple surgeries at different times. However, combining procedures also increases the complexity of the surgery, and patients should discuss the potential benefits and risks with their surgeon during the consultation.

The Psychological Impact of Neck Lift Surgery

For many individuals, the neck is a key area that contributes to their overall appearance, and concerns about the neck’s appearance can have a significant psychological impact. A well-performed neck lift, with or without gland removal, can help individuals feel more comfortable with their appearance and can improve their overall quality of life.

However, it is important for patients to approach the surgery with realistic expectations and an understanding that the goal of the procedure is improvement rather than perfection. Open communication with the surgeon, as well as having a clear understanding of the expected results, can help ensure that patients are satisfied with the outcome.

Long-Term Outcomes and Maintenance

The results of a neck lift with gland removal are often long-lasting, but they are not immune to the effects of ageing. Over time, the skin and tissues of the neck may continue to age, and some degree of sagging may eventually return. However, most patients find that the improvements achieved through surgery provide lasting benefits and that their neck and jawline retain a more defined appearance for many years.

To maintain the results of a neck lift, patients should adopt a healthy lifestyle that includes good skincare practices, a balanced diet, and avoiding smoking, which can accelerate the ageing process. Regular use of sunscreen is also important to protect the skin from UV damage, which can contribute to premature ageing.

In some cases, non-surgical treatments such as laser therapy, ultrasound skin tightening, or injectable treatments may be recommended to maintain the results of a neck lift. These treatments can help address minor signs of ageing and keep the neck area looking its best without the need for additional surgery.

Potential Risks, Considerations, and Limitations of SGR

Every surgical procedure carries some level of risk. Submandibular gland removal, while beneficial in certain circumstances, is no exception. It involves operating in a delicate area of the neck, where important nerves and vessels are located.

General surgical risks include bleeding, the formation of a haematoma (a collection of blood beneath the skin), and the possibility of infection. These are managed through sterile technique, post-operative care, and appropriate medication, but they still remain potential complications.

Specific risks associated with submandibular gland removal include injury to the marginal mandibular nerve, which controls the muscles that move the lower lip. Damage to this nerve may result in temporary or, rarely, permanent asymmetry of facial movement. There is also a risk of developing a salivary fistula, where saliva leaks from the surgical site. While rare, this condition may require additional treatment or monitoring.

Another consideration is the potential for dry mouth if both glands are removed, although this is uncommon. Most people retain adequate saliva production from the remaining glands. Some patients may also experience prolonged swelling, numbness, or a sensation of tightness during healing.

Limitations of the procedure must be discussed openly. It is not a preventative measure and will not stop future changes related to ageing or weight fluctuations. Additionally, not all visible fullness in the neck is due to gland prominence, and removal may not always provide a dramatic change in appearance.

Patients should approach this decision with a clear understanding of risks, alternatives, and realistic expectations. A thorough consultation that includes discussion of personal medical history, lifestyle, and goals is essential.

Recovery after SGR and Aftercare

Recovery following a deep neck lift with submandibular gland removal varies from one individual to another. The duration and experience depend on factors such as age, skin quality, general health, and the extent of the surgery.

In the initial days after surgery, swelling and bruising are common and most noticeable. These usually peak within the first week and gradually decrease over the following weeks. Patients may experience mild to moderate discomfort, which is typically managed with prescribed or over-the-counter medication. A feeling of tightness in the neck is also common and should ease with time.

During the early recovery period, patients are often instructed to wear a compression garment. This garment supports healing tissues, reduces swelling, and helps maintain the newly contoured shape of the neck. Sleeping with the head elevated and avoiding bending or heavy lifting are common recommendations to reduce swelling and promote circulation.

Wound care instructions are given and should be followed precisely. These may include how to clean the incision sites, when to change dressings, and when to return for follow-up visits. Stitches, if not dissolvable, are usually removed within the first week or two.

Most individuals can return to light daily activities within ten to fourteen days. However, strenuous exercise, direct sun exposure, and other high-impact activities are typically restricted for at least four to six weeks. Full healing and final results may take several months to become apparent.

Clear communication with the surgical team during recovery is vital. Any signs of excessive pain, sudden swelling, fever, or discharge should be reported immediately.

Cost Considerations for Deep Neck Surgery with Gland Removal

The cost of deep neck lift surgery with submandibular gland removal can vary widely. It is influenced by a number of factors, including the location of the clinic, the experience and qualifications of the surgeon, and whether the procedure is performed in a hospital or a private surgical centre.

Additional costs may include pre-operative imaging, anaesthesia, facility fees, post-operative garments, medications, and follow-up visits. In general, the inclusion of gland removal makes the procedure more complex and can increase both the duration and cost of the surgery.

Patients should expect to receive a detailed cost estimate during the consultation process. This estimate should clearly outline all elements of the surgery, from preparation to aftercare, to avoid unexpected expenses.

In most countries, aesthetic or elective procedures such as this are not covered by public or private health insurance. Financing options or payment plans may be offered by some clinics, but these vary by provider and region.

Careful financial planning is recommended. Choosing a surgeon based solely on cost is not advised; qualifications, experience, and facility safety should be prioritised.

Choosing the Right Surgeon

Submandibular gland removal is a specialised component of deep neck lift surgery that should only be performed by a suitably qualified and experienced practitioner. Patients are encouraged to thoroughly research providers and ensure they meet regional standards for surgical training and licensure.

In the United States, look for surgeons who are certified by the American Board of Plastic Surgery or the American Board of Facial Plastic and Reconstructive Surgery. In the United Kingdom, practitioners should be listed on the General Medical Council (GMC) Specialist Register. In Australia, appropriate training includes Fellowship of the Royal Australasian College of Surgeons (FRACS) in Plastic Surgery.

Beyond credentials, it is important to confirm that the surgeon performs this specific procedure regularly and in a certified surgical facility. During the consultation, patients can ask how many times the surgeon has performed submandibular gland removal and whether they have experience with cases similar in complexity.

Viewing anonymised before-and-after images of previous patients can be helpful, as can reading independent patient reviews or testimonials. Facility accreditation and support staff training are also important to ensure a safe surgical environment.

Open, respectful communication between patient and surgeon is essential. Patients should feel comfortable asking questions and be given clear, evidence-based answers in return.

Questions to Ask Your Surgeon During Your Consultation

Preparing for a consultation with a qualified practitioner is an important step in the decision-making process. Here are some key questions that individuals may wish to ask:

• What is your assessment of my neck anatomy, and do you believe my submandibular glands are contributing to the fullness I see under my jaw?
• Can you explain the risks of this procedure in my specific case, including how you would protect the facial nerve during surgery?
• Are there alternatives to gland removal that might still achieve my aesthetic goals?
• How often do you perform this component of the deep neck lift, and what are your typical outcomes?
• Can you show me before-and-after photographs of patients who have undergone this procedure, particularly those with similar concerns or anatomy?
• What should I expect during the healing period, and how long will it take to see the final results?
• What follow-up care do you provide, and what happens if I experience a complication or need revision surgery?
• Am I a good candidate for submandibular gland removal? – Understanding whether your anatomy makes you a suitable candidate for gland removal is crucial.
• What are the risks associated with gland removal, and how do you minimise them? – Knowing the potential risks and how your surgeon plans to mitigate them can help you feel more confident in your decision.
• What kind of results can I realistically expect? – It is important to have a clear understanding of the likely outcome of the procedure and to ensure that it aligns with your expectations.
• How much experience do you have with neck lift surgery and gland removal? – Choosing a surgeon with the right experience and expertise is essential for achieving the best possible result.
• What will the recovery process be like, and what can I do to ensure a smooth recovery? – Understanding the recovery process and your role in it will help you prepare for the post-operative period.
• Will I need any additional procedures to achieve my desired result? – In some cases, additional procedures such as liposuction or a facelift may be recommended to achieve optimal results.

FAQs About Submandibular Gland Removal in Deep Neck Lift

Is this a routine part of a deep neck lift?

• No, removal of the submandibular glands is not routinely included in a deep neck lift. It is typically reserved for patients whose gland prominence significantly impacts the appearance of the neck.

Does gland removal affect saliva production?

• Most people have multiple salivary glands, and the removal of one or even two submandibular glands usually does not cause dry mouth. Other glands continue to produce saliva.

Is it possible to reposition the glands instead of removing them?

• In some cases, repositioning may be attempted. However, this may not provide as effective or lasting a result as removal when gland size and placement are the main issue.

How long will the results of the deep neck lift with gland removal last?

• While the effects are long-lasting, ageing and lifestyle factors may influence how the results appear over time. Maintaining a stable weight and healthy habits can help prolong the outcome.

Will the incision scars be visible?

• Incisions are usually placed in discreet areas, such as under the chin or behind the ears. With proper care, scarring tends to fade significantly and is often minimally noticeable.

Can both submandibular glands be removed at the same time?

• Yes, in appropriate cases, both submandibular glands may be removed during the same procedure. This depends on the individual’s anatomy and the surgeon’s recommendation.

Final Thoughts about Gland Removal

The removal of submandibular glands in a deep neck lift is a highly individualised decision. When performed in the right patient by an experienced and qualified surgeon, it can contribute to a more refined and balanced neck contour. However, it also introduces a level of complexity and risk that must be carefully considered.

This article has presented an educational overview to help individuals explore this option in a thoughtful, evidence-informed way. Every person’s anatomy, goals, and health profile is unique, and no single procedure is right for everyone.

The most important step is to engage in a thorough consultation with a credentialed practitioner who understands your needs and can guide you through a personalised plan. With careful planning and clear communication, patients can make choices that align with their values, safety, and long-term well-being.

Meet Dr. Bryan H. Pruitt, MD, FACS

• Location: Dallas, Texas.
• Dr Bryan Pruitt is a board-certified plastic surgeon renowned for his expertise in facial rejuvenation, particularly his signature facelift and deep neck lift.
• With over two decades of experience, he has established a reputation for delivering natural-looking results that enhance his patients’ features without overt signs of surgery.​
• Recognition: Consistently named among the “Best Doctors in Dallas” by D Magazine and recognized as a “Texas Super Doctor” by Texas Monthly, Dr. Pruitt’s peers have acknowledged his excellence in the field.​
• Patient-Centered Approach: Dr. Pruitt is known for dedicating his full attention to each patient, performing only one facelift surgery per day to ensure meticulous care and optimal outcomes.​
• Global Clientele: His practice attracts high-profile individuals, including celebrities, athletes, and executives, from across the United States and internationally, all seeking his discreet, confidential and refined surgical expertise.​
• Patient Testimonials: In hundreds of online reviews, patients consistently praise Dr. Pruitt for his professionalism, attention to detail, and the natural-looking results he achieves. 
• Patient Experience: Many highlight the supportive environment of his practice and the personalized care they receive throughout their surgical journey.​​

Dr. Bryan Pruitt’s commitment to excellence, combined with his surgical skill and aesthetic sensibility, solidifies his position as one of the top deep neck lift surgeons in the United States for facelift & necklift.

Further Reading

• Best Deep Neck Lift Surgery in Dallas Texas
• Neck Lift in San Antonio | Dr Baumholtz