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 and risks of hematoma and nerve damage. LigaSure (Valleylab, Boulder, CO) is a bipolar energy-based instrument that permanently seals vessels and connective tissue. Its use 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 using the LigaSure device, and the complication rates were documented.
Results: Patients were followed up for an average period of 21 months (range, 9 months to 2.4 years). No perioperative intraglandular bleeding or postoperative hematoma was observed in any patient. No sialoma cases were observed postoperatively. Only 3 patients underwent repeated seroma aspirations. Transient lower lip weakness was observed in 7 patients, who all recovered in the first 6 months postoperatively.
Conclusion: LigaSure-assisted SMG excision in deep-plane neck lift surgery was found to be technically easier to perform, time saving, safe, and highly effective in preventing hematoma and intraoperative bleeding.
Clincal question/level of evidence: Therapeutic, IV.
Copyright © 2024 by the American Society of Plastic Surgeons.