2025-06-10
While many are familiar with botox injections for salivary gland reduction, submandibular gland removal surgery is far less common—even among plastic surgery clinics in Gangnam.
Interestingly, Dr. Connell, a pioneer in facelift surgery, has emphasized the value of submandibular gland removal for facelift for over 30 years. Despite its proven benefits, the high level of surgical difficulty makes it rare, especially for aesthetic purposes.
In this article, we compare botox injection and surgical options for salivary gland hypertrophy treatment.
The face contains three major salivary glands:
Located behind the jaw and under the ear; largest and most important for saliva production
Beneath the jaw; often targeted for reduction due to its location and lower functional importance
Under the tongue; smallest
💡 TIP: Removal of the submandibular gland rarely causes dry mouth, as it's not the major contributor to saliva.
Why treat the Submandibular Gland?
A beautiful neck, as shown in the image above, depends on a well-defined mandibular line (1) and a sharp angle between the neck and submentum (4). When the submandibular gland protrudes, it can interfere with achieving this ideal contour.
Many patients ask: “Is it functionally safe to remove the submandibular gland?”
The answer is yes—as long as it's performed by an experienced Korean Plastic Surgeon. Since other glands compensate and the submandibular gland plays a secondary role, functional impairment is rare.
For patients over 30, skin elasticity begins to decline. Removing the gland alone may cause the overlying skin to sag like a deflated balloon.
Combining gland removal with muscle tightening (platysmaplasty) and neck lifting ensures a more contoured and natural jawline.
Three possible scenarios can occur.
After fat is removed from the double chin area, prominence of gland can be more visible.
While looking down, the muscle relaxes and gland can be seen easily.
If the gland is not reduced during the neck lift, patients often notice a visible bulge or “pop-up” under the neck.
Unfortunately, cosmetic gland removal is not covered by health insurance unless it's for tumor removal or medical necessity.
Globally, only a few surgeons perform submandibular gland removal for cosmetic reasons due to its complexity. However, its necessity is gaining recognition in medical literature, including publications like Clinics in Plastic Surgery.
At Noonopi Plastic Surgery, our mini neck lift includes:
❗Note: We don’t remove excess skin in mini neck lifts, because improving contour often increases the need for skin surface area—not less.
There is no fixed rule. Like a sculptor working with clay, surgeons must assess and tailor the removal based on real-time anatomy during surgery.
Ideal for patients in their 40s or younger with minimal skin laxity.
For significant sagging, a traditional neck lift with skin excision behind the ears may be more appropriate.