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

Background Neck lifting is a cornerstone of cervicofacial rejuvenation, with optimal cervicomandibular contour often requiring management of subplatysmal structures, including the submandibular glands (SMGs). Partial excision of the superficial lobe may be performed in selected patients but remains controversial due to concerns regarding bleeding, nerve injury, and other complications. The LigaSure Exact Dissector is a bipolar vessel-sealing device designed for use in confined anatomical spaces and has been adopted by some surgeons for SMG management during aesthetic neck surgery. Objectives To evaluate the short-term safety and postoperative complication profile associated with partial submandibular gland excision performed 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-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 performed during the study period, 80 patients (65%) underwent bilateral partial SMG excision. The mean patient age was 58.7 years (range, 34-73 years); 57 patients (71%) were female and 23 (29%) were male, with a mean body mass index of 24.5. Postoperative 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 of which resolved within 8 weeks. No cases of permanent nerve injury, sialoma, infection, or xerostomia were observed. Conclusions In this retrospective series, partial submandibular gland excision performed using the LigaSure Exact Dissector was associated with a low rate of short-term postoperative complications. These findings suggest that LigaSure-assisted SMG excision can be performed safely in appropriately selected patients undergoing aesthetic neck lift surgery. Further comparative studies are needed to evaluate outcomes relative to other surgical techniques and energy modalities.