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Submandibular Gland Reduction in Aesthetic Surgery of the Neck: Review of 112 Consecutive Cases

BACKGROUND: The indications for reduction of excessive submandibular gland volume in aesthetic rejuvenation of the neck have been well described, as has the surgical anatomy and the surgical technique. Despite this, submandibular gland reduction does not appear to be widely adopted, nor have signifi...

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Autores principales: Mendelson, Bryan C., Tutino, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548544/
https://www.ncbi.nlm.nih.gov/pubmed/25989302
http://dx.doi.org/10.1097/PRS.0000000000001526
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author Mendelson, Bryan C.
Tutino, Roberto
author_facet Mendelson, Bryan C.
Tutino, Roberto
author_sort Mendelson, Bryan C.
collection PubMed
description BACKGROUND: The indications for reduction of excessive submandibular gland volume in aesthetic rejuvenation of the neck have been well described, as has the surgical anatomy and the surgical technique. Despite this, submandibular gland reduction does not appear to be widely adopted, nor have significant case series been reported in the literature. This review of a consecutive series of aesthetic submandibular gland reductions was undertaken to provide a perspective about its place in neck contouring. METHODS: A retrospective chart review was conducted of all patients on whom the senior author (B.C.M.) had performed submandibular gland reduction for aesthetic reasons. Complications and reoperations were specifically analyzed. RESULTS: Submandibular gland reduction was performed in 112 of 736 consecutive face lifts between 2002 and 2013, an incidence of 13 percent in primary face lifts and 25 percent in secondary face lifts. The median patient age was 57 years, and 87 percent were women. Major complications were those requiring early reoperation (1.8 percent) to manage significant hematomas; one was potentially fatal. Minor complications (10.8 percent) were managed nonoperatively. Submandibular sialocele (4.5 percent) and marginal mandibular branch neurapraxia (4.5 percent) were the most frequent, and all resolved fully by 3 months. Significantly, no patient reported a permanent dry mouth. CONCLUSIONS: The complication rate with submandibular gland reduction is comparable to that of a neck lift with platysma plication alone, with some additional specific risks: (1) catastrophic airway compression from bleeding deep in the neck, (2) significant increase of neurapraxias in secondary neck lifts, and (3) a moderate incidence of benign submandibular sialocele. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
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spelling pubmed-45485442015-09-09 Submandibular Gland Reduction in Aesthetic Surgery of the Neck: Review of 112 Consecutive Cases Mendelson, Bryan C. Tutino, Roberto Plast Reconstr Surg Cosmetic: Original Articles BACKGROUND: The indications for reduction of excessive submandibular gland volume in aesthetic rejuvenation of the neck have been well described, as has the surgical anatomy and the surgical technique. Despite this, submandibular gland reduction does not appear to be widely adopted, nor have significant case series been reported in the literature. This review of a consecutive series of aesthetic submandibular gland reductions was undertaken to provide a perspective about its place in neck contouring. METHODS: A retrospective chart review was conducted of all patients on whom the senior author (B.C.M.) had performed submandibular gland reduction for aesthetic reasons. Complications and reoperations were specifically analyzed. RESULTS: Submandibular gland reduction was performed in 112 of 736 consecutive face lifts between 2002 and 2013, an incidence of 13 percent in primary face lifts and 25 percent in secondary face lifts. The median patient age was 57 years, and 87 percent were women. Major complications were those requiring early reoperation (1.8 percent) to manage significant hematomas; one was potentially fatal. Minor complications (10.8 percent) were managed nonoperatively. Submandibular sialocele (4.5 percent) and marginal mandibular branch neurapraxia (4.5 percent) were the most frequent, and all resolved fully by 3 months. Significantly, no patient reported a permanent dry mouth. CONCLUSIONS: The complication rate with submandibular gland reduction is comparable to that of a neck lift with platysma plication alone, with some additional specific risks: (1) catastrophic airway compression from bleeding deep in the neck, (2) significant increase of neurapraxias in secondary neck lifts, and (3) a moderate incidence of benign submandibular sialocele. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV. Lippincott Williams & Wilkins 2015-09 2015-08-27 /pmc/articles/PMC4548544/ /pubmed/25989302 http://dx.doi.org/10.1097/PRS.0000000000001526 Text en Copyright © 2015 by the American Society of Plastic Surgeons This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License (http://creativecommons.org/licenses/by-nc-nd/3.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
spellingShingle Cosmetic: Original Articles
Mendelson, Bryan C.
Tutino, Roberto
Submandibular Gland Reduction in Aesthetic Surgery of the Neck: Review of 112 Consecutive Cases
title Submandibular Gland Reduction in Aesthetic Surgery of the Neck: Review of 112 Consecutive Cases
title_full Submandibular Gland Reduction in Aesthetic Surgery of the Neck: Review of 112 Consecutive Cases
title_fullStr Submandibular Gland Reduction in Aesthetic Surgery of the Neck: Review of 112 Consecutive Cases
title_full_unstemmed Submandibular Gland Reduction in Aesthetic Surgery of the Neck: Review of 112 Consecutive Cases
title_short Submandibular Gland Reduction in Aesthetic Surgery of the Neck: Review of 112 Consecutive Cases
title_sort submandibular gland reduction in aesthetic surgery of the neck: review of 112 consecutive cases
topic Cosmetic: Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548544/
https://www.ncbi.nlm.nih.gov/pubmed/25989302
http://dx.doi.org/10.1097/PRS.0000000000001526
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