Why You Should Not Remove The Salivary Gland During A Neck Lift

25 Feb Why You Should Not Remove The Salivary Gland During A Neck Lift

A defined neck and jawline may contribute to overall facial balance. For many women and men in Perth considering facial surgery, a neck lift is one way to address changes in the lower face that occur over time. However, some individuals exploring this procedure may come across the idea of salivary gland removal, particularly the submandibular gland, being included as part of the operation.

At Dr Guy Watts’ clinic in Perth, patients receive clear, evidence-based advice on every aspect of facial surgery. While each person has unique anatomy and personal goals, the removal of a salivary gland during a neck lift is NOT routinely recommended and should only be considered in carefully selected circumstances.

Dr Guy Watts, Specialist Plastic & Reconstructive Surgeon in Perth, Western Australia, takes a measured approach to neck surgery that prioritises both form and function. This article explains why preserving the salivary glands is typically preferred and outlines the potential risks of their removal.

Understanding The Role Of The Salivary Glands

The body contains several salivary glands that play important roles in oral function. Of these, the submandibular glands sit just beneath the lower jaw on both sides of the neck. They produce a large proportion of the saliva that helps lubricate the mouth, supports digestion and contributes to overall oral comfort.

These glands may become more noticeable in some individuals as natural changes in soft tissue, skin elasticity and fat distribution occur with time. In certain head positions or lighting, this can lead to a visible fullness under the jaw, which some may assume is due to fat or muscle changes.

Occasionally, this fullness is attributed to the salivary gland itself. Some surgical techniques have suggested removing or reducing the gland to change the shape of the area under the jaw. However, doing so is not typically necessary and involves important clinical considerations.

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What A Neck Lift Typically Addresses

A neck lift, also known as platysmaplasty, is a surgical procedure designed to adjust changes in the lower face and neck. These changes may relate to:

• The position or tone of the platysma muscle
• Localised soft tissue beneath the chin
• Changes to skin support in the neck region

The procedure often involves modifying the muscle, removing select fat deposits, and adjusting skin positioning to support a smoother transition between the face and neck. Each neck lift performed by Dr Guy Watts in Perth is tailored to suit the individual, with careful attention to underlying anatomy and longer-term outcomes.

The salivary glands are not typically included in a standard neck lift. Altering or removing them introduces additional complexity and may affect oral function.

Why Salivary Gland Removal Is Rarely Part Of Aesthetic Surgery

While submandibular gland removal has been discussed in certain surgical literature, it is not routinely indicated in aesthetic neck surgery. Dr Guy Watts generally advises against it except in rare cases where there is a clearly identified clinical reason. The following considerations support this approach.

1. Nearby Structures Increase The Risk Of Nerve Injury

The submandibular gland sits close to several important anatomical features, including:

• The marginal mandibular nerve, which supports movement of the lower lip
• The lingual nerve, which is involved in tongue sensation
• The facial artery and vein, which supply the region

Surgical access to this area carries a risk of temporary or permanent disruption to these structures. Even small injuries can affect facial movement or sensation, which may impact daily functions such as speaking or eating.

For elective procedures such as a neck lift, the preservation of normal function is central to planning. Dr Guy Watts prioritises approaches that reduce the likelihood of complications and support a steady recovery.

2. Salivary Glands Support Important Physiological Functions

The submandibular glands are responsible for a significant amount of resting saliva production. Saliva plays a vital role in protecting oral tissues, preventing bacterial overgrowth and maintaining moisture in the mouth.

Removing a gland can reduce total saliva output, particularly in patients who may already have reduced flow due to age or certain medications. This may lead to dry mouth (xerostomia), which can affect oral comfort, dental health and speech.

These are meaningful changes that may have ongoing effects. As such, gland removal is only considered when there is a clinical need, and not simply to adjust the shape of the area beneath the jaw.

3. Postoperative Complications Can Occur

Procedures involving salivary gland removal may be associated with complications such as:

• Sialocele, a collection of saliva under the skin
• Salivary fistula, an abnormal drainage tract of saliva
• Haematoma or bleeding
• Swelling or fluid accumulation
• Infection or prolonged inflammation

These outcomes can extend recovery and may require further treatment. In the context of elective facial surgery, the risks involved with gland removal may outweigh the benefits, especially when other options are available to support the result.

4. Other Techniques Can Often Address Neck Appearance

In most cases, Dr Guy Watts can achieve the changes a patient is seeking by using more targeted and less invasive strategies, including:

• Submental fat removal to adjust volume under the chin
• Platysma modification to support the underlying neck structure
• Layered tissue repositioning to improve definition without deep dissection
• Skin adjustment to manage redundancy without excessive removal

These techniques aim to produce a result that suits the individual’s features while preserving deeper functional structures such as the salivary glands.

In some cases, if the gland is particularly prominent and clearly affecting the visual shape of the neck, limited modification may be discussed. This is always done with detailed consent, full explanation of the risks and only where clearly supported by the anatomy.

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Why A Thoughtful, Individualised Approach Matters

Dr Guy Watts, Specialist Plastic & Reconstructive Surgeon in Perth, has extensive experience in facial surgery and approaches each case individually. He considers not just the appearance of the neck, but also its function, tissue condition and how any changes may affect the patient over time.

Some individuals may feel concerned about a sense of fullness under the jaw or softness in the lower face. However, this is not always caused by the gland. Dr Watts performs a comprehensive examination to determine what structures are contributing to the concern.

The treatment plan is then developed using a careful balance of aesthetic goals and clinical judgement. Where possible, procedures are designed to protect essential structures and reduce the chance of complications. Gland removal is only considered when it is medically justifiable.

Long-Term Considerations For Neck Surgery

A neck lift is not only about short-term changes. The best results are those that are consistent, stable and integrated with the person’s natural features. Supporting healthy tissue, rather than removing it unnecessarily, helps preserve structure and function over time.

Salivary gland removal may not prevent the natural ageing process. Facial features will continue to change with time. In many cases, more conservative techniques offer a similar change in appearance with fewer potential side effects and a more predictable recovery.

Neck Lift Surgery Before and After Photos

Photo disclaimer:
Each surgical procedure produces unique outcomes influenced by factors such as body composition, skin tone, laxity, age, and genetics. The before-and-after photographs displayed are of actual patients and are provided for informational purposes only.

What To Expect At Your Consultation In Perth

If you are considering neck lift surgery, or have questions about the structures beneath the jawline, an individual consultation is the best way to receive appropriate information.

During your visit with Dr Guy Watts in Perth, you can expect:

• A discussion about your concerns, lifestyle and expectations
• An anatomical assessment to determine which features are contributing to the appearance of the neck
• An explanation of treatment options tailored to your goals
• A detailed overview of the risks, benefits and recovery process

Dr Watts offers a supportive, respectful environment where patients can ask questions and make decisions at their own pace.

FAQs About Salivary Gland Management During Neck Lift Surgery