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Submandibular gland removal: what the operation involves | CION Cancer Clinics
Submandibular gland removal is an operation to take out one of the two saliva glands that sit under the jaw, through a cut in a skin crease of the upper neck. It is done under general anaesthetic, usually with a short hospital stay. It is used for tumours, stones that keep returning and repeated infection. The main risks come from three small nerves nearby, and most problems are temporary. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What does submandibular gland removal involve?
- Why would the gland need to come out?
- What happens from the day of surgery to the first weeks at home?
- What words will you see on the report?
- What can go wrong after this operation?
- What do families often believe about this surgery?
- Common questions about submandibular gland removal
The short answer
What does submandibular gland removal involve?
The surgeon removes the whole submandibular gland, the saliva gland that sits just under the jawbone on one side, through a cut in the upper neck. You are fully asleep for it. The cut is placed in a natural skin crease, so the scar sits below the jawline as it heals.
Where the gland is and what it does
You have two submandibular glands, one on each side, roughly under the back teeth. Each makes saliva and sends it into the mouth through a small tube that opens under the tongue. When one is removed, the gland on the other side and your other saliva glands keep working.
Who this operation does not suit
Not every lump under the jaw needs the gland removed. A swollen lymph node, a small stone that can be taken out through the mouth, or an infection that settles with medicine may all be handled in other ways. Some people are not fit enough for a general anaesthetic, and for them the team weighs the lump against the risk of the operation. Whether surgery is right for you is a decision for your treating team.
The reasons
Why would the gland need to come out?
There are four common reasons.
A lump in the gland
Many lumps in this gland are not cancer, but a larger share are cancers than in the bigger gland in front of the ear. The gland is removed whole so the lump can be examined under a microscope.
Usually tested first with
- An ultrasound of the neck
- A fine needle test of the lump
- Sometimes a CT or MRI scan
Stones that keep coming back
A stone can block the tube and make the gland swell painfully at mealtimes. Many stones can be taken out through the mouth. Removing the whole gland is kept for stones that cannot be reached or keep returning.
Repeated infection
A gland that has been infected many times can become hard, scarred and stop working properly. If antibiotics keep failing, removing it may end the cycle of swelling and pain.
A cancer that has been confirmed
The surgeon may also remove lymph nodes in the upper neck, and sometimes nearby tissue. This is a bigger operation than removing the gland alone.
Lymph nodes are small glands that filter fluid and can trap cancer cells.Not sure whether this applies to you?
Ask an oncologist
!
Neck swelling after surgery cannot wait
If the neck on the operated side swells quickly and feels tight in the hours or days after surgery, tell the ward nurse at once. If you are at home, go to the nearest emergency department. A collection of blood under the wound can press on the airway. Noisy breathing, trouble breathing or being unable to swallow your own saliva needs care the same day. Do not wait to see if it settles.
Step by step
What happens from the day of surgery to the first weeks at home?
-
Before the day
You will have blood tests and a check that you are fit for a general anaesthetic. Tell the team about every medicine you take, especially blood thinners such as aspirin or clopidogrel. The team will tell you whether and when to pause any of them. Do not stop one on your own.
-
The operation
You are asleep throughout. The surgeon makes a cut in a crease below the jaw, finds and protects the nearby nerves, ties off the blood vessels and the tube of the gland, and lifts the gland out. A thin drain is often left in the wound.
-
The first night
The neck feels stiff and sore, and swallowing may be uncomfortable. Pain is usually controlled with tablets. You can normally drink and eat soft food once you are fully awake.
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Going home
The drain usually comes out once it stops collecting much fluid, and many people go home soon after. You will be shown how to keep the wound dry.
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The first weeks
Bruising and a firm swelling under the cut settle gradually. Most people return to desk work fairly soon, but heavy lifting waits until your surgeon says it is safe. The pathology report is usually discussed at your follow-up visit.
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On your report
What words will you see on the report?
- Sialadenitis
- Inflammation of a saliva gland, usually from infection or a blocked tube. It is not cancer.
- Sialolith
- A stone in a saliva gland or in its tube.
- Pleomorphic adenoma
- The most common salivary tumour that is not cancer. It grows slowly and is removed so it does not keep growing.
- Carcinoma
- A cancer. The report names the type, such as adenoid cystic or mucoepidermoid carcinoma, and the type guides what happens next.
- Margin
- The rim of normal tissue around what was removed. A clear margin means no cancer cells were seen at the edge.
- Lymph node
- A small bean-shaped gland that filters fluid. The report says how many were removed and whether any contained cancer.
Being straight with you
What can go wrong after this operation?
Most people recover without a lasting problem. The risks that matter come from three small nerves that run close to the gland, and from bleeding or infection in the wound. This page cannot give you a figure for your own risk. That depends on why the gland is being removed and how much tissue has to come out with it.
The lower lip
A nerve that moves the corner of the lower lip runs just above the gland. If it is bruised or stretched, your smile can look lopsided for a while. This is usually temporary and improves over weeks to months. Lasting weakness is uncommon.
The tongue
One nerve gives feeling and taste to one side of the tongue. Another moves the tongue. Injury to either is less common than lip weakness, but it can make the tongue feel numb or move less well on one side.
The wound and the scar
Bleeding under the wound, infection and a numb patch of skin around the scar can all happen. The skin numbness often shrinks with time.
If a cancer is growing into a nerve, the surgeon may need to remove that nerve on purpose. Ask before the operation whether this is expected.Commonly believed
What do families often believe about this surgery?
"Removing a saliva gland will leave the mouth dry for life."
You have several other saliva glands, including the matching one on the other side. They usually keep the mouth comfortable. A dry mouth is far more likely if radiotherapy is given to the area afterwards.
"If they are removing the whole gland, it must be cancer."
The whole gland is removed for stones and repeated infection too. Even when there is a lump, many turn out not to be cancer. Only the pathology report can tell you what it was.
"A needle test will make a tumour spread."
A fine needle test is a routine, safe way to plan the operation. It helps the surgeon decide how much to remove. Putting it off because of a feared spread only delays the plan.
"Home remedies can shrink the lump, so surgery is not needed."
No herbal paste, diet or oil has been shown to shrink a salivary tumour. Waiting to try them can give a cancer time to grow. Ask your team what waiting would mean for you.
Questions we are asked
Common questions about submandibular gland removal
How long does the operation take?
It is usually a fairly short operation when only the gland is removed. It takes longer if lymph nodes or other tissue come out too. Add the time spent getting ready and waking up, so your family should expect you to be away from the ward for a few hours.
How long will I stay in hospital?
Many people stay one or two nights. The drain, if one was placed, usually decides the timing, because it comes out once the wound stops collecting fluid. A bigger operation for cancer can mean a longer stay. Your surgeon will tell you what to expect for your own operation before the day.
Will the scar be visible?
The cut is placed in a natural crease below the jawline, so once healed it is often hidden in the shadow of the jaw. It looks pink and feels firm at first, then fades over many months. Everyone scars differently, and darker skin can sometimes form a thicker scar.
Can I eat normally after surgery?
Most people can drink and eat soft food on the day of surgery or the day after. Chewing may feel stiff for a few days. If one side of your tongue feels numb, let very hot tea and food cool first, and chew slowly so you do not bite your tongue without noticing.
Will I lose my sense of taste?
Most people do not. Taste at the front of one side of the tongue can change if the nerve beside the gland is stretched, and this often improves. The other side of the tongue and the back of the mouth still taste normally, so food usually tastes much as it did before.
When can I go back to work?
People with desk jobs often return within a week or two, once they feel comfortable and the wound is healing well. Jobs with heavy lifting or dusty conditions may need longer. If you had a larger operation for cancer, or need further treatment, your return will be planned around that.
Will I need radiotherapy afterwards?
Not usually for stones, infection or a tumour that is not cancer. If the report shows a cancer, the team looks at its type, its grade, the margin and the lymph nodes before deciding. Radiotherapy is sometimes advised after surgery to lower the chance of the cancer coming back. That decision waits for the report.
Is this surgery covered by Aarogyasri or insurance?
Often, yes, particularly when it is part of cancer treatment. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled. What is covered depends on your scheme and the reason for surgery. Call the helpline with your card details and the team will check your cover.
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Sources
- NHS — Salivary gland cancer
- Cancer Research UK — Salivary gland cancer
- National Cancer Institute — Salivary gland cancer treatment (PDQ), patient version
- Cancer.Net — Salivary gland cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Nerves at Risk in Submandibular SurgeryThe lip and tongue nerves near the gland, explainedTongue Movement and Sensation AfterwardsWhat numbness feels like and how it recoversThe Neck Scar After Submandibular SurgeryHow the scar heals and how to care for itDry Mouth After Salivary Gland SurgeryWhy most people do not have a lasting dry mouthBenign vs Malignant Salivary Tumours: What ChangesHow the report changes the plan
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