Submandibular Gland Excision (Salivary Gland Removal)

What Is the Submandibular Gland?

The submandibular glands are salivary glands located beneath the jaw (under the chin). They produce saliva, which helps with chewing, swallowing, and digestion.

Why Is Surgery Needed?

Surgery to remove the submandibular gland may be recommended for:

• Salivary gland stones (sialolithiasis) causing blockage
• Recurrent infections or swelling
• Chronic pain or inflammation
• A mass or tumor (benign or cancerous)

When symptoms persist or do not improve with other treatments, gland removal may be the best option.

What Is a Submandibular Gland Excision?

A submandibular gland excision is a surgical procedure to remove one of the salivary glands beneath the jaw.

The remaining salivary glands typically produce enough saliva, so most patients do not notice a significant change in saliva production.

How Is the Procedure Performed?

• Performed under general anesthesia
• A small incision is made just below the jawline, usually in a natural skin crease
• The gland is carefully removed
• Nearby nerves controlling lip movement and tongue sensation are identified and protected
• A drain may be placed temporarily to prevent fluid buildup

Procedure time: approximately 1–2 hours

What to Expect After Surgery

• Most patients go home the same day or after an overnight stay
• Mild pain, swelling, and bruising under the jaw are common
• A drain (if placed) is usually removed within a few days
• A small scar will be present but typically fades over time

Recovery

• Return to normal activities within 1–2 weeks
• Avoid strenuous activity for at least 1–2 weeks
• Final pathology results (if applicable) are usually available within about 1 week

Benefits of Surgery

• Relief of pain, swelling, or infection
• Removal of stones or blockage
• Diagnosis and treatment of masses
• Prevention of recurrent symptoms

Risks

Submandibular gland excision is generally safe, but potential risks include:

• Bleeding or infection
• Numbness of the tongue or lower lip
• Temporary weakness of the lower lip
• Scar formation
• Fluid collection (seroma)

Post-Operative Instructions

How You Will Feel

You may feel drowsy and tired after surgery due to anesthesia. Most patients rest the evening after surgery and regain energy over the next day. Light activity is encouraged as tolerated.

Nausea

Nausea can occur despite preventive medications.

• Rest and limit activity
• Start with clear liquids
• Avoid heavy foods
• Symptoms usually resolve within 8–10 hours

Pain / Discomfort

• Mild discomfort around the incision and neck is common
• Use prescribed pain medication as directed
• Take pain medication the night of surgery and the following morning
• After 1–2 days, acetaminophen (Tylenol) is often sufficient

Swelling

• Swelling and bruising may increase during the first night
• Apply ice packs gently for the first 48 hours
• Sleep with your head elevated
• Most swelling improves within 4–5 days

Fever

• Low-grade fever (up to 101°F) is common
• Use acetaminophen (Tylenol) or ibuprofen (Motrin) as needed

Antibiotics / Infection

• Antibiotics may be prescribed after surgery
• Infection is uncommon
• Call your doctor if you notice:
  • Increasing redness
  • Swelling
  • Pain with fever

Activity

• Resume light activity as tolerated
• Avoid heavy lifting or straining for at least 1 week
• Avoid strenuous exercise for 2 weeks
• Most patients return to work within 5–7 days

Diet

• No specific restrictions
• Resume a regular diet as tolerated

Wound Care / Dressings

• Incision closed with stitches or skin glue (Dermabond)
• Dermabond will peel off in 7–10 days (no removal needed)
• If a drain is present:
  • Follow instructions for care
  • Record daily output
  • Usually removed within a few days

Hygiene

• Shower normally after 24 hours if no drain is present
• If a drain is present, wait to shower until after the drain is removed
• Clean gently with soap and water
• Avoid scrubbing the incision

Numbness

• Temporary numbness around the incision, cheek, or ear is common
• Sensation typically returns over weeks to months

Facial Weakness

• Temporary mild weakness near the corner of the mouth can occur
• Usually resolves within a few weeks
• Permanent weakness is rare

Follow-Up

• With drain: visit in 2–3 days for removal
• Without drain: visit in 1–2 weeks for wound check
• Confirm your appointment with the surgery coordinator if needed

When to Call the Doctor

• Fever greater than 102°F not responding to medication
• Sudden increase in neck swelling
• Difficulty breathing

Emergency Room

• If you need to go to the Emergency Room, please use the following guidelines
• Patients age 16 and older: Centennial Medical Center Frisco
• Patients under 16: Children’s Medical Center Plano