Removal of a salivary gland (submandibular or parotid) (Submandibular gland excision or parotidectomy)

An operation to remove a salivary gland — the parotid in front of the ear or the submandibular gland under the jaw — usually because of a lump, a blockage that cannot be cleared, or repeated infections.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

A salivary gland is usually removed for a lump, a stone or blockage that cannot be cleared, or repeated infections — and any lump is examined under the microscope.
For the parotid, the key risk is to the facial nerve that moves the face; weakness is often temporary but can occasionally be permanent.
For the submandibular gland, nerves that move the lower lip and supply feeling and taste to the tongue lie close by and can be affected.
Removing one gland does not cause a dry mouth, because the other salivary glands keep working.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeSurgery to remove a salivary gland (parotid or submandibular)

AnaestheticUsually general anaesthetic

How long it takesAround 1 hour for submandibular; often 2–4 hours for parotid

Hospital stayUsually one night in hospital (a drain is often used)

Time off workOften about 1–2 weeks, depending on the gland and your job

When you'll see resultsWound and swelling settle over weeks; the laboratory result on a lump usually takes 1–2 weeks

On the NHS?Available on the NHS when there is a clear clinical reason

A general guide. Your surgeon will give you advice for your situation.

Best fit

Removes a lump so it can be examined under the microscope and treated

Pause if

A stone or blockage that can still be cleared while keeping the gland may not need the gland removing.

Main recovery point

You usually stay one night with a drain in place. Expect soreness and swelling. Take painkillers as advised. The drain is often removed the next morning...

Good aftercare

Clear, frank discussion of facial nerve risk beforehand, and monitoring of nerve function afterwards.

First 24 hours

You usually stay one night with a drain in place. Expect soreness and swelling. Take painkillers as advised. The...

First week

Keep the wound dry as advised. Swelling and bruising settle gradually. Skin stitches are usually removed around...

Weeks 2–6

The wound continues to heal and the scar starts to fade. Any temporary facial or lip weakness, or tongue numbness...

Months

The scar fades further. Numbness near the wound improves, though the ear lobe may stay numb after parotid surgery...

Medical line illustration of parotid salivary gland surgery for Removal of a salivary gland (submandibular or parotid). — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is removal of a salivary gland?

Saliva is made by several glands. The two that are most often removed are the parotid gland, which sits just in front of and below the ear, and the submandibular gland, which lies under the jaw. An oral and maxillofacial surgeon (or head and neck surgeon) carries out this surgery.

The usual reasons to remove a gland are a lump in the gland (most are not cancer, but some are), a stone or blockage that cannot be cleared while keeping the gland, or a gland that keeps getting infected or painful. When a lump is removed, it is always examined under the microscope.

For a parotid lump, the surgeon usually removes the part of the gland containing the lump (often the outer, 'superficial', part) while carefully protecting the facial nerve, which runs through the parotid and controls the muscles of the face. For the submandibular gland, the whole gland is usually removed through a cut in the upper neck, with care taken around the nerves that move the lower lip and supply feeling and taste to the tongue.

Removing one salivary gland does not leave you with a dry mouth, because the other glands carry on making saliva. The biggest specific concern, especially for the parotid, is the risk to the facial nerve.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Submandibular gland excision

The whole gland under the jaw is removed through a cut about two inches long in the upper neck, just below the jawline. A drain is often used and most people stay one night.

Superficial parotidectomy

The outer part of the parotid containing a lump is removed, through a cut in front of the ear extending under the jaw, while carefully identifying and protecting the facial nerve.

Total or extended parotidectomy

More of the gland is removed when a lump is larger, deeper, or is or may be cancerous. This carries a higher risk to the facial nerve and is planned with the specialist team.

Removal with neck node surgery

If a gland cancer is confirmed or suspected, lymph nodes in the neck may also be removed and other treatments discussed by a head and neck multidisciplinary team.

Parotid gland vs submandibular gland surgery

	Parotid	Submandibular
Where	In front of/below the ear	Under the jaw
Cut	In front of the ear, under the jaw	In the upper neck below the jaw
Key nerve risk	Facial nerve (moves the face)	Lower-lip, tongue feeling and taste nerves
Operation length	Often 2–4 hours	Around 1 hour
Specific extra	Frey's syndrome, ear-lobe numbness	Lower-lip weakness, tongue numbness

The gland removed determines which nerves are most at risk and what to expect afterwards. Your surgeon will explain the specific risks for your gland and your reason for surgery.

Preparing for your surgery

See the surgeon to confirm why the gland needs removing and which operation is planned.
Have any scans and tests needed, such as an ultrasound and sometimes a needle sample (biopsy) of a lump.
Ask specifically about the facial nerve (for the parotid) and the lower-lip and tongue nerves (for the submandibular).
Tell the team about all medicines, especially blood thinners, and any bleeding tendencies.
Follow fasting instructions for the general anaesthetic and arrange a lift home and support.
Stop smoking if you can, as it slows wound healing.
Plan about 1–2 weeks off work, and ask how and when you will get any laboratory results.

What happens

Salivary gland surgery is usually done under a general anaesthetic, so you are asleep.

For the submandibular gland, the surgeon makes a cut about two inches (5 cm) long in the upper neck, just below the jawline, and removes the whole gland, taking care around the nearby nerves. This usually takes about an hour. A small drain is often left in overnight to remove fluid, and most people stay one night.

For the parotid, the cut runs in front of the ear and curves under the jaw. The surgeon carefully finds and protects the facial nerve, which runs through the gland, then removes the part of the gland containing the lump. This is more delicate and usually takes longer, often two to four hours. A drain is often used and most people stay one night.

Any lump removed is sent to the laboratory and examined under the microscope. The wound is closed with stitches, and you are given advice on wound care, the drain and what to watch for before you go home.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

A stone or blockage that can still be cleared while keeping the gland may not need the gland removing.
A lump that can be safely watched, or sampled rather than removed, in selected cases.
Active infection of the gland usually needs settling before planned removal.
Very frail patients may be offered a more limited approach, or monitoring, after discussing risks and benefits.
You are not fit for the general anaesthetic until other health problems are managed.

Delay surgery if…

The gland is acutely infected and needs treating first.
Your blood-thinning medicine or a bleeding tendency has not been assessed.
Important results (such as scans or a biopsy) are still awaited and would change the plan.
You are unwell, or cannot arrange the support and lift home that surgery needs.
You are pregnant — timing and approach should be discussed with your team.

Alternatives to discuss

Gland-sparing stone removal (including sialendoscopy) if the blockage can be cleared.
Watching a small, benign-looking lump in selected cases, with review.
Treating recurrent infections with antibiotics and supportive measures where appropriate.
For confirmed cancer, treatments such as radiotherapy alongside surgery, decided by the specialist team.
The NHS pathway rather than private care if speed is not the priority.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

General anaesthetic

The usual choice for both parotid and submandibular gland removal, so you are asleep; arrange a lift home and support.

Benefits

Removes a lump so it can be examined under the microscope and treated
Clears a blockage or stone that could not be removed while keeping the gland
Stops repeated infections, swelling or pain from a damaged gland
Removes a gland cancer, where present, as part of a wider treatment plan
Does not cause a dry mouth, as the other salivary glands keep working

Risks & complications

More common

Pain, swelling and bruising around the wound for a week or two
A scar in the upper neck (submandibular) or in front of the ear and under the jaw (parotid)
Numbness of the skin near the wound, including the ear lobe after parotid surgery
A drain in place for the first day and some fluid collection afterwards

Less common

Temporary weakness of part of the face after parotid surgery, or of the lower lip after submandibular surgery
Tingling, numbness or altered taste of part of the tongue after submandibular surgery
Wound infection, sometimes needing antibiotics
A collection of saliva or fluid under the parotid wound (a sialocele or seroma)
Bleeding or a blood collection (haematoma) under the wound

Rare but serious

Permanent weakness of part of the face after parotid surgery, or of the lower lip after submandibular surgery
Lasting numbness or altered taste of the tongue after submandibular surgery
A persistent salivary leak through the parotid wound
Frey's syndrome after parotid surgery (sweating or flushing of the cheek when eating)
Serious problems related to the general anaesthetic

The most important specific risk in parotid surgery is to the facial nerve, which runs through the gland and moves the muscles of the face. Some weakness is common straight after surgery and usually recovers, but it can occasionally be permanent, and the risk is higher for larger, deeper or cancerous lumps. In submandibular surgery, the nerves that move the lower lip and give feeling and taste to the tongue lie close by; weakness or numbness is usually temporary but can rarely last. Frey's syndrome (sweating of the cheek when eating) is common after parotid surgery but is usually mild and treatable. Ask your surgeon about your personal nerve risk and how it will be monitored.

Published figures to discuss

Risk depends on which gland is removed, the size and nature of the lump, and how close it lies to key nerves. For the parotid, facial nerve weakness is the main concern; for the submandibular gland, the lower-lip and tongue nerves are most at risk. The ranges below are cautious figures from the surgical literature for benign disease; risks are higher for cancer or larger, deeper lumps, and these are population figures rather than guarantees for any one person.

Figure	Reported range	How to interpret it	Source / confidence
Temporary facial nerve weakness after parotid surgery (benign disease)	Reported very widely, roughly 9–65% across studies, usually recovering over weeks to months	Wide range reflects different surgery and reporting; most weakness recovers.	Parotidectomy — StatPearls (NCBI Bookshelf)ncbi.nlm.nih.govPublished figure
Permanent facial nerve weakness after parotid surgery (benign disease)	Usually low in experienced benign-parotid series, often around 1–3%, but older/larger series report up to about 9% or more	Risk is higher for larger, deeper or cancerous lumps.	Parotidectomy — StatPearls (NCBI Bookshelf)ncbi.nlm.nih.govPublished figure
Marginal mandibular nerve weakness (lower lip) after submandibular surgery	Reported from about 1–20%, mostly temporary; permanent weakness is rare for benign disease	Usually due to bruising of the nerve while it is protected during surgery.	Parotidectomy — StatPearls (NCBI Bookshelf)ncbi.nlm.nih.govPublished figure
Lingual nerve injury (tongue feeling/taste) after submandibular surgery	Reported around 4% in one series, about half of which were permanent	The nerve giving feeling and taste to the tongue runs close to the gland.	Parotidectomy — StatPearls (NCBI Bookshelf)ncbi.nlm.nih.govPublished figure
Frey's syndrome after parotid surgery	Common if actively tested, with literature ranges roughly 17–100%; symptomatic cases are fewer and usually treatable	Sweating or flushing of the cheek when eating; managed with antiperspirant or other treatments.	Parotidectomy — StatPearls (NCBI Bookshelf)ncbi.nlm.nih.govPublished figure

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Most people recover from salivary gland surgery over about one to two weeks for the wound and swelling, though numbness near the scar and any nerve effects can take longer to settle, and the ear lobe may stay numb after parotid surgery.

First 24 hours

You usually stay one night with a drain in place. Expect soreness and swelling. Take painkillers as advised. The drain is often removed the next morning before you go home.

First week

Keep the wound dry as advised. Swelling and bruising settle gradually. Skin stitches are usually removed around 5–7 days. Most people rest at home and avoid strenuous activity.

Weeks 2–6

The wound continues to heal and the scar starts to fade. Any temporary facial or lip weakness, or tongue numbness, is reviewed and usually improves. The laboratory result on any lump is discussed with you.

Months

The scar fades further. Numbness near the wound improves, though the ear lobe may stay numb after parotid surgery. Frey's syndrome, if it develops, may appear over the following months and can be treated.

What's normal — and not a worry

Soreness, swelling and bruising around the wound for a week or two
Numbness of the skin near the scar, including the ear lobe after parotid surgery
A firm, slightly lumpy scar that softens and fades over months
A wait of a week or two for the full laboratory result on any lump
Some temporary facial or lower-lip weakness, or tongue numbness, that usually improves

Aftercare

Keep the wound clean and dry as instructed until it has healed.
Take painkillers as advised and any antibiotics exactly as prescribed.
Look after the drain as shown if you go home with one, and know when it will be removed.
Avoid strenuous activity, heavy lifting and stretching the neck in the early days.
Support the wound and avoid sudden movements while it heals.
Protect the healing scar from the sun once the wound has closed.
Report any facial or lip weakness, or tongue numbness, so it can be monitored.
Attend follow-up to remove stitches, get any results and check healing and nerve function.

Before-surgery checklist

Scans and any needle sample (biopsy) done before surgery
Recommended painkillers and any antibiotics collected
A lift home and support for the first day or two arranged
About 1–2 weeks off work booked
Sun protection for the scar
A date for stitch removal and results
The clinic's contact number saved for problems

Scars and how they heal

Submandibular surgery leaves a scar about two inches long in the upper neck, just below the jawline. Parotid surgery leaves a scar in front of the ear that curves under the jaw, designed to follow natural lines. Scars are red and slightly firm at first and usually fade over several months to become much less noticeable. After parotid surgery the area in front of the ear may look slightly hollow where gland tissue is removed, and the ear lobe is often numb. Ask your surgeon what scar to expect for your operation.

⚠ Get urgent help if…

Spreading redness, heat, swelling or pus around the wound (possible infection)
A high temperature or feeling generally unwell
A rapidly swelling, tense or very painful wound (possible bleeding under the skin)
Bleeding that does not stop with gentle pressure
New or worsening weakness of the face or lower lip
Difficulty swallowing or breathing, or swelling spreading down the neck — seek urgent help
A clear fluid leaking persistently from a parotid wound

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result means the gland or lump is removed, the wound heals, and any laboratory result guides what happens next. Most lumps are not cancer, and removing one salivary gland does not cause a dry mouth.

For the parotid, some facial weakness straight after surgery is common and usually recovers over weeks to months, but it can occasionally be permanent. For the submandibular gland, lower-lip weakness or tongue numbness is usually temporary. If a lump turns out to be cancer, your care is guided by a head and neck multidisciplinary team, and further treatment such as more surgery or radiotherapy may be discussed. A good surgeon explains your nerve risk honestly and how it will be checked.

How long it lasts

Once a gland is removed, the problem it caused — a lump, blockage or repeated infection — is usually resolved for good, and the remaining glands keep your mouth moist. If a lump was a type that can recur, or was cancerous, you will have follow-up appropriate to the diagnosis. Any facial or lip weakness, tongue numbness or Frey's syndrome is usually judged settled within several months, though some changes (such as ear-lobe numbness after parotid surgery) can be lasting.

Combining with other procedures

Salivary gland surgery is sometimes combined with removal of neck lymph nodes if a cancer is confirmed or suspected, and with reconstruction if a larger area is removed. For confirmed cancer, the head and neck multidisciplinary team plans whether further treatment such as more surgery or radiotherapy is needed. These are usually planned alongside, or after, the gland surgery rather than as part of a routine removal.

Follow-up & long-term care

You will usually be reviewed to remove stitches, check healing, discuss any laboratory result, and monitor nerve function. If a lump was benign and fully removed, you may need little further review. If it was cancer, or a type that can recur, you will have a follow-up plan guided by the specialist team. You should be told who to contact for problems such as infection, a salivary leak, or weakness that is not improving.

Report any facial or lower-lip weakness, or tongue numbness, so it can be monitored.
Attend any follow-up appropriate to the diagnosis, especially if a lump can recur or was cancer.
Use a roll-on antiperspirant or ask about other treatments if Frey's syndrome develops after parotid surgery.
Keep up good mouth hygiene and regular dental care.

Revision and secondary surgery reality

If a lump is found to be cancer, or reaches the margin, further surgery or other treatment may be needed.
A persistent salivary leak (sialocele) after parotid surgery sometimes needs further treatment.
Facial or lip weakness that does not recover may need specialist assessment and, occasionally, further surgery.
A lump type that can recur may need re-operation in the future.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

Clear, frank discussion of facial nerve risk beforehand, and monitoring of nerve function afterwards.
Written advice on wound and drain care, painkillers and warning signs, with a named contact.
A defined plan for getting laboratory results and what they mean.
Treatment offered for Frey's syndrome if it develops after parotid surgery.
Specialist team involvement and a follow-up plan if a lump is cancer or can recur.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Which gland is removed and whether it is a partial or total parotidectomy
Whether neck lymph node surgery or reconstruction is also needed
The general anaesthetic, theatre fees and length of stay
Scans and any needle sample (biopsy) needed beforehand
Laboratory (histology) fees for examining the gland or lump
The surgeon's fee, follow-up appointments and any further treatment guided by the result

Make sure your written quote includes

The surgeon's fee and what operation it covers
The general anaesthetic, theatre fees and expected length of stay
Scans and any needle sample (biopsy) before surgery
Laboratory (histology) fees for the gland or lump
Follow-up appointments and stitch removal
The cancellation policy
What happens, and who pays, if a complication occurs or further treatment is recommended

On the NHS? Salivary gland removal is available on the NHS when there is a clear clinical reason; private care may be used for speed or choice, but the approach and nerve-protecting care should be the same.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Choosing a surgeon safely

Check your surgeon is on the GMC Specialist Register for this area.
Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good surgeon will welcome every one of these.

Why does my gland need removing, and which operation are you planning?
What is my personal risk to the facial nerve (parotid) or the lower-lip and tongue nerves (submandibular)?
How will the facial nerve be protected and monitored during and after surgery?
Could my lump be cancer, and will my case be discussed by a head and neck team?
What scar should I expect, and how likely is Frey's syndrome after parotid surgery?
What is the plan if a nerve problem does not recover?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the surgeon who carries out my operation, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this operation not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Will my face be left weak after parotid surgery?

Some weakness of part of the face is common straight after parotid surgery, because the facial nerve runs through the gland and is carefully protected. In most people this recovers over weeks to months, but a small number have permanent weakness. The risk is higher for larger, deeper or cancerous lumps.

Will removing a gland give me a dry mouth?

No. You have several salivary glands, so removing one does not cause a dry mouth — the others carry on making saliva.

What is Frey's syndrome?

After parotid surgery, as nerves recover they can connect with sweat glands in the skin, causing sweating or flushing of the cheek when you eat. It is common but usually mild, and can be treated with a roll-on antiperspirant or sometimes other treatments.

What nerves are at risk in submandibular surgery?

Three nerves lie close to the gland: one that moves the lower lip, one that gives feeling and taste to the tongue, and one that moves the tongue (rarely affected). Damage is usually temporary bruising of a nerve, but can occasionally be lasting.

Is the lump likely to be cancer?

Most salivary gland lumps are not cancer, but some are, which is why the lump is examined under the microscope. If it is cancer, your care is guided by a head and neck specialist team and may involve further treatment.

Can I have this on the NHS?

Yes — salivary gland removal is available on the NHS when there is a clear clinical reason. Some people use private care for speed or choice; the approach should be the same.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Salivary gland stones Cambridge University Hospitals NHS — Removal of submandibular salivary gland Hull University Teaching Hospitals NHS — Removal of parotid gland Parotidectomy — StatPearls (NCBI Bookshelf) Submandibular salivary gland excision — StatPearls (NCBI Bookshelf) Marginal mandibular nerve in submandibular surgery — safety study (PMC) Facial nerve palsy after benign parotidectomy — PMC Incidence of postoperative facial weakness in parotid tumour surgery Frey's syndrome after parotidectomy — review

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.