Basket submandibular gland suspension.
BACKGROUND
Correction of a ptotic submandibular gland is a considerable challenge in neck rejuvenation. The procedures available to treat this condition either provide only short-term success or carry perceived risk of significant postoperative morbidities. The authors describe a new technique, basket submandibular gland suspension, for the effective long-term treatment of submandibular fullness.


METHODS
The ptotic gland is accessed through a submental incision or combined submental and rhytidectomy incision. The gland is protected in a piece of deep temporal fascia or superficial musculoaponeurotic system graft. Two Mitek fixation sutures are placed at each corner of the fascia and secured to the medial surface of the mandible after passing through a small portion of glandular tissue to create a basket-like structure that lifts and suspends the gland.


RESULTS
Nineteen submandibular glands were suspended on 10 patients. The average follow-up was 1.8 years. Six patients (11 glands) experienced a complete elimination of bilateral submandibular fullness, whereas three patients had minimal residual fullness. One patient with a hypertrophic gland required resection after 1 year due to residual ptosis. None of the patients developed dryness of the mouth; loss of taste; or difficulties with phonation, articulation, or swallowing. One patient required removal of the suspension sutures due to infection. One patient developed temporary paresthesia along the lingual nerve distribution. One patient noted a palpable Mitek anchor on one side, which was removed without subsequent adverse outcome.


CONCLUSIONS
Basket submandibular gland suspension produces effective long-term results for the elimination of submandibular fullness in patients who have normal sized, ptotic glands.
Guyuron
Bahman
B
Cleveland, Ohio From the Department of Plastic Surgery, Case Western Reserve University.
Jackowe
David
D
Iamphongsai
Seree
S