Partial Submandibular Gland Resection in Deep Neck Surgery: An Assessment of Safety Using the LigaSure Exact Dissector.

BACKGROUND

Optimal cervicomandibular contour often necessitates management of subplatysmal structures, including the submandibular glands (SMGs). Partial SMG excision may enhance neck definition but remains controversial because of concerns regarding bleeding and other potential complications. The LigaSure Exact Dissector (Medtronic, Minneapolis, MN) is a bipolar vessel-sealing device that has been adopted by some surgeons for SMG management during aesthetic neck surgery.

OBJECTIVES

To evaluate the short-term safety and postoperative complication profile of partial SMG excision using the LigaSure Exact Dissector during aesthetic neck lift surgery.

METHODS

A retrospective observational case series was conducted of patients undergoing partial SMG excision as part of primary neck lift procedures between August 2023 and January 2025. All SMG excisions were performed using the LigaSure Exact Dissector. Patient demographics and postoperative complications were recorded. Outcomes were analyzed descriptively, with a minimum follow-up of 3 months (mean follow-up, 5 months).

RESULTS

Of 123 neck lift procedures, 80 patients (65%) underwent bilateral partial SMG excision. Mean age was 58.7 years (range, 34-73 years); 57 patients (71%) were female and 23 (29%) male, with a mean body mass index of 24.5. Complications included seroma in 3 patients (3.75%), minor hematoma in 1 patient (1.25%), and transient lower-lip weakness in 4 patients (5%), all resolving within 8 weeks. No permanent nerve injury, sialoma, infection, or xerostomia occurred.

CONCLUSIONS

Partial SMG excision using the LigaSure Exact Dissector was associated with a low rate of short-term complications. These findings suggest the technique can be safely performed in appropriately selected patients undergoing aesthetic neck lift surgery. Further comparative studies are warranted.

LEVEL OF EVIDENCE: 4 (Therapeutic).