Ligasure-assisted submandibular gland excision in deep plane neck lift: review of 83 patients

Background: In performing a neck lift, the size and location of the submandibular gland (SMG) must be evaluated to achieve the ideal neck contour. Many surgeons, however, avoid SMG excision because of the technical difficulty, risks of hematoma, and nerve damage. LigaSure™ (Valleylab, Boulder, CO) is a bipolar energy-based instrument that permanently seals vessels and connective tissue which can make the SMG excision step easy and safe by reducing surgical risks. Methods: A total of 83 patients who underwent SMG excision between 2018 and 2022 were included in the study. All patients’ SMGs were partially excised by LigaSure™ (LS), and the complication rates were documented. Results: Patients were followed up for an average of 21 months (9 months–2.4 years). No perioperative intraglandular bleeding or postoperative hematoma was observed in any of the patients. No sialoma was observed in any of the patients postoperatively. Only three patients underwent repeated seroma aspirations. Transient lower lip weakness was observed in 7 patients which all recovered in the first 6 months postoperatively. Conclusions: LS-assisted SMG excision in deep neck lift surgery was found to be technically easier, time-saving, safe, and highly effective in preventing hematoma and intraoperative bleeding.