A preservation facelift takes the same deep plane technique that has made facelift surgery so effective and refines how it is performed to protect more of the skin's natural blood supply. The result is a lift that looks just as natural, with an easier recovery. For some patients, this approach is paired with a more targeted step below the jaw: reducing the submandibular glands, so a defined jawline is not undone by a stubborn bulge in the neck.
At OG Aesthetics in Menlo Park, Dr. Dominick Gadaleta and Dr. Timothy Ortlip built their practice on a philosophy of restraint: lift what needs lifting, and leave the rest of the face alone. Here, they explain how preservation techniques and submandibular gland reduction work together to refine the jawline and neck.
What Makes a Facelift a "Preservation" Facelift?
Traditional deep plane facelifts release the same ligaments to reposition the SMAS, the muscle layer beneath facial skin, but they call for wider skin dissection to get there. A preservation approach keeps that dissection tighter, protecting more of the skin's natural blood supply while still achieving the same lift. A 2025 paper in Plastic and Reconstructive Surgery Global Open describes how newer preservation methods, including a rotating pedicle flap placed along the jawline, sharpen jawline definition while keeping that vascular supply intact.
The payoff for patients is a more comfortable recovery, without giving up the refined, natural-looking outcome that has made deep plane technique the gold standard in facial rejuvenation.
Why the Neck Can Still Look Full After a Facelift
Even a well-executed facelift or neck lift can leave some fullness under the chin when the cause sits deeper than skin and fat. A few structures are usually behind it:
- Submandibular glands: Paired salivary glands beneath the jaw that can enlarge or drop with age.
- Digastric muscles: Small muscles under the chin that can widen the central neck when more prominent.
- Deep neck fat: Fat positioned beneath the platysma, the muscle layer across the front of the neck, out of reach of standard liposuction.
When one of these is driving the fullness, tightening skin and muscle alone will not fully resolve it.
What Submandibular Gland Reduction Involves
The submandibular glands are one of three pairs of major salivary glands, sitting just below the jaw. During a facelift or neck lift, a surgeon can access and partially reduce these glands through the same incisions already used for the lift, adding no separate procedure or scar.
A review of 736 consecutive facelifts published in Plastic and Reconstructive Surgery found submandibular gland reduction was performed in about 13 percent of primary facelifts and 25 percent of secondary ones, with a low complication rate and no reported cases of permanent dry mouth. The study's authors concluded the risk profile is comparable to a neck lift alone.
Is Submandibular Gland Reduction Right for You?
Not every patient needs this step. It is typically reserved for those with visibly prominent or displaced glands, where skin and muscle tightening alone would leave a bulge along the jaw.
Published in 2025, a review in Aesthetic Surgery Journal pooled outcomes from more than 3,000 patients across published studies. Major complications, such as hematoma or nerve injury, occurred in under 4 percent of cases. The most common issue was temporary neck firmness, seen in about one in five patients. During a consultation, Dr. Gadaleta or Dr. Ortlip can evaluate your neck anatomy and let you know if gland reduction fits your goals.
Considering a Preservation Facelift? Dr. Gadaleta and Dr. Ortlip Can Help
A preservation facelift paired with thoughtful deep-neck contouring can deliver a refined, natural jawline with less downtime along the way. Dr. Gadaleta and Dr. Ortlip bring the artistry and precision OG Aesthetics is known for to every consultation, and will help you decide which techniques fit your face and your goals. Schedule a consultation to find out more.
Sources
- Sadati K, et al. Advancements in Face Lift Techniques: Preservation Face Lift With a Rotating Pedicle Flap. Plast Reconstr Surg Glob Open. 2025.
- Mendelson BC, Tutino R. Submandibular Gland Reduction in Aesthetic Surgery of the Neck: Review of 112 Consecutive Cases. Plast Reconstr Surg. 2015.
- Morel SBA, et al. Aesthetic Submandibular Gland Resection: A Review of Complication Incidence and Prevention. Aesthet Surg J. 2025.
- National Institute of Dental and Craniofacial Research. Saliva and Salivary Gland Disorders.
This information is provided for educational purposes only and does not replace a consultation with a board-certified plastic surgeon. Outcomes, risks, and suitability vary from patient to patient.
