Safety Profile of Submandibular Gland Reduction and Parotid-Tail Minimal Shaving in Deep Neck Lifting: A 341-Patient East Asian Series.

BACKGROUND

Deep-plane facelift has become widely adopted in facial rejuvenation, and its extension into deep neck contouring has highlighted the importance of addressing submandibular and parotid fullness when these contribute to clinically evident jawline blunting. Although many studies have reported complications following deep neck lifting and submandibular gland (SMG) reduction, reported rates remain heterogeneous because of inconsistent definitions and attribution of gland-specific events. Parotid-tail minimal shaving, originally proposed by Talei, has gained attention as a conservative option for posterolateral contour refinement; however, its clinical safety profile has not been systematically evaluated, particularly in East Asian patients.

OBJECTIVES

The aim of this study was to evaluate the overall safety and procedure-specific complication profiles of SMG reduction and parotid-tail minimal shaving performed during deep neck lifting in an East Asian cohort.

METHODS

This retrospective single-center study included 341 consecutive East Asian patients who underwent deep neck lifting between August 2024 and July 2025. SMG reduction was performed in 240 patients, and parotid-tail minimal shaving in 81 patients; 20 patients underwent both procedures during the same operation. Gland-related complications were assessed during postoperative follow-up of up to 6 months.

RESULTS

Among 341 patients, hematoma was observed in 4 (1.17%), infection in 3 (0.88%), and seroma in 6 (1.76%). Transient cervical-branch weakness was observed in 5 patients (1.47%) and marginal mandibular nerve weakness in 2 patients (0.59%). SMG-related sialocele was observed in 1 patient (0.29%), whereas parotid-related sialocele was observed in 3 patients (0.88%). No permanent nerve injury was observed.

CONCLUSIONS

Selective salivary-gland reduction during deep neck lifting demonstrated low complication rates in this large East Asian series. Both SMG reduction and capsule-preserving parotid-tail minimal shaving appear safe when selectively applied.

LEVEL OF EVIDENCE 4 RISK: For image description, please refer to the figure legend and surrounding text.