Introduction: The Quest for a Defined Neckline
As a double board-certified plastic surgeon specializing in facial rejuvenation here in Istanbul, one of the most frequent questions I encounter during consultations for neck lift surgery revolves around the submandibular glands. Patients, often well-researched and coming from the USA, UK, Canada, or Australia, ask: "Dr. CBS, will you need to remove my glands to give me the best neck contour?" It's a valid question, especially as discussion around this specific maneuver has increased online. However, the answer isn't a simple yes or no.
Understanding the Submandibular Glands
Located just beneath the jawline on either side of the neck, the submandibular glands are essential salivary glands. In some individuals, these glands can be naturally larger or may become more prominent with age or weight fluctuations, contributing to fullness or bulging in the upper neck area, detracting from a smooth, sharp jawline contour.
Read my blog post: Platysmaplasty for Necklift
Gland Removal in Neck Contouring: When is it Necessary?
While removing or reducing prominent submandibular glands can indeed enhance the results of a neck lift or neck contouring procedure in specific cases, it is absolutely not a routine step for every patient. In my extensive experience, performing face and neck rejuvenation surgery daily, I find gland removal necessary in approximately 20% of my neck contouring cases.
Unfortunately, the removal of these glands is sometimes promoted almost as a standard, "must-have" component of advanced neck lifting by some practitioners. I believe this can be misleading. Performing submandibular gland removal when it isn't indicated is an unnecessary surgical step that carries its own specific risks and potential complications, such as bleeding, nerve injury (affecting the lower lip), or issues with saliva production and drainage.
Read my blog post: The Secret to a Youthful Face: Why Your Neck Holds the Key
The Deciding Factor: Expert Manual Examination
So, how do we determine if gland removal is appropriate? The key lies in a thorough manual examination during the pre-operative consultation. An experienced facial plastic surgeon can assess the neck structure, feel the size and position of the glands, differentiate gland prominence from excess fat or loose muscle (platysma bands), and determine their actual contribution to the neck fullness relative to other factors. This hands-on assessment is crucial. It allows me to decide, often during the surgery itself after evaluating the underlying structures directly, whether full removal, partial removal, or no removal is the optimal approach for that individual patient.
Personalized Approaches for Unique Necks
Every patient's anatomy is unique. I've had cases, like the one shown in the photo above, where prominent glands were the primary concern, and addressing them (in that case, primarily gland removal and contouring) made a significant difference with minimal or targeted skin/muscle work. In other cases, tightening the neck muscles (platysmaplasty) in the midline and performing thorough chin and neck liposuction provides a beautiful contour without touching the glands at all. Sometimes, only a partial reduction of the gland is needed. The goal is always to achieve the best, most natural-looking, and safest result for your specific anatomy and aesthetic goals.
Visit our information page: Neck Lift
Post-Operative Care When Glands are Addressed
If gland removal or reduction is performed, specific post-operative care is important. Because these glands produce saliva, we need to manage this temporarily. I typically prescribe a special diet for about a week after surgery designed to reduce saliva stimulation. In some instances, I may also inject Botulinum Toxin (Botox) into the remaining gland tissue pre-operatively or intra-operatively to temporarily decrease saliva production further, ensuring a smoother recovery.
Visit our information page: Face Lift
Conclusion: Trust Experience, Not Hype
Achieving a refined, youthful neck contour is a cornerstone of facial rejuvenation. While submandibular gland removal can be a powerful tool in the right circumstances, it's a nuanced decision that requires significant experience and careful, individualized assessment. My philosophy is built on providing honest, expert evaluation and tailoring surgery to the patient's actual needs, not following trends. We achieve the 'cool' factor through exceptional, natural results based on sound surgical principles, not unnecessary procedures. If you're considering a neck lift, let's discuss your specific anatomy and goals to determine the safest and most effective plan for you.
Visit our information page: Full Face Rejuvenation
Don't forget to watch real plastic surgery patient stories !
