<\/p>\n
The fear has been hard to shake. In 2021, when The Aesthetic Society surveyed its members about certain \u201cnovel or less mainstream\u201d procedures, 89% said they don\u2019t perform submandibular gland reduction, with most citing \u201cdanger to the patient\u201d as the main reason. The majority also reported that they had not learned the procedure in training. Ultimately, the society concluded that \u201cwhen comparing the perceived complication rates with data published in the literature, particularly when looking at rates of serious or life-threatening complications, plastic surgeons overestimate the risk of procedures with which they are less familiar.\u201d<\/p>\n
In 2026, however, gland reduction is gaining ground. For the better part of two decades, Dr. O\u2019Daniel has taught facelift cadaver courses\u2014dissection-focused anatomy labs for surgeons aiming to hone their skills or acquire new ones. For the longest time, he says, very few attendees knew how to treat the glands or expressed any interest in learning. But this past year, when Dr. O\u2019Daniel asked a group of surgeons how many routinely reduce the glands, two-thirds raised their hands\u2014and the rest were eager to learn how to do it safely.<\/p>\n
The uptick is being driven by patients who are requesting the procedure. \u201cThey often come in knowing more facelift terminology than some plastic surgery residents,\u201d Dr. Savetsky says (not entirely in jest). And they\u2019re \u201cpushing for better and better results,\u201d adds Garrett Locketz, MD, a double board-certified facial plastic surgeon in Denver. The savviest among them have come to realize that \u201cin some people, the submandibular gland is the thing that stands between a good neck and an outstanding neck.\u201d<\/p>\n
With esteemed experts sharing conflicting opinions on social, some patients are naturally confused about the merits of gland contouring. \u201cThere\u2019s a group of surgeons who are doing this routinely, and they promote it in a way that makes you think if you\u2019re not getting it, you\u2019re going to have a lesser result,\u201d Dr. Rosenberg says. Is there any truth to this?<\/p>\n
L. Mike Nayak, MD, seems to think so. \u201cIt really just comes down to: How good of a result do you want and what are you willing to do to get it,\u201d says the double board-certified facial plastic surgeon from St. Louis. Going under the platysma to debulk glands and other tissues, as one does in a deep neck lift, demands the utmost proficiency and adds time and risk to the operation, he says, but it typically garners a cleaner, crisper outcome than a traditional neck lift (which tightens muscle, redrapes skin, and perhaps removes some of the fat lining the skin).<\/p>\n
\u201cI truly believe there\u2019s no reason for a debate if the question is, Which technique gives a sharper neckline?\u201d adds board-certified San Francisco plastic surgeon Dino Elyassnia, MD, when asked about his peers\u2019 polarizing viewpoints. \u201cThere\u2019s a drastic difference in the shape of the neck when you treat the deep layer.\u201d<\/p>\n
To understand why, imagine your mandible, or lower jawbone, as a container of sorts. (Trust: Four different surgeons explained gland prominence using this analogy.) In someone with a deep, well-defined jawline, \u201cthe gland is completely hidden within the confines of the horseshoe of the mandible,\u201d Dr. Nayak says. But if the gland expands or droops, which is common with age, a portion of it can escape those confines, bulging out below the jawbone and appearing as a lump in the neck. Even if your glands aren\u2019t especially sizable or saggy, they can still show themselves due to bone loss. Inevitably, \u201cthe mandible shrinks over time, so the depth of our container is getting smaller,\u201d adds Dr. Nayak. But age isn\u2019t always the instigator: \u201cSome people are born with a small container and\/or too much volume, and their necks tend to go straight down,\u201d notes Dr. O\u2019Daniel. In a 2021 study, he found that the majority of volume in the neck is related to the submandibular glands, the digastric muscles, and the deep fat, which can only be accessed and addressed by going under the platysma.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"
The fear has been hard to shake. In 2021, when The Aesthetic Society surveyed its members about certain \u201cnovel or less mainstream\u201d procedures, 89% said they don\u2019t perform submandibular gland reduction, with most citing \u201cdanger to the patient\u201d as the main reason. The majority also reported that they had not learned the procedure in training. […]<\/p>\n","protected":false},"author":1,"featured_media":1680,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[55],"tags":[],"class_list":["post-1679","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-beauty"],"_links":{"self":[{"href":"https:\/\/sasgai.com\/index.php\/wp-json\/wp\/v2\/posts\/1679","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sasgai.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sasgai.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sasgai.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/sasgai.com\/index.php\/wp-json\/wp\/v2\/comments?post=1679"}],"version-history":[{"count":0,"href":"https:\/\/sasgai.com\/index.php\/wp-json\/wp\/v2\/posts\/1679\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/sasgai.com\/index.php\/wp-json\/wp\/v2\/media\/1680"}],"wp:attachment":[{"href":"https:\/\/sasgai.com\/index.php\/wp-json\/wp\/v2\/media?parent=1679"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sasgai.com\/index.php\/wp-json\/wp\/v2\/categories?post=1679"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sasgai.com\/index.php\/wp-json\/wp\/v2\/tags?post=1679"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}