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Removal of salivary gland lumps - the facial nerve first, always.

Removal of parotid, submandibular, sublingual or minor salivary gland lumps by a consultant head-and-neck surgeon. Facial nerve monitoring as standard, ultrasound-guided cytology up front, and a clear conversation about scar, nerve and gustatory sweating before you consent.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What removal of salivary gland lumps costs privately in the UK.

Indicative ranges across our partner units.

In short

£8,500–£14,500, home in 1–2 nights.

Procedure Indicative range
Extracapsular dissection (small benign parotid lump) £6,500–£10,500
Superficial parotidectomy £8,500–£14,500
Total parotidectomy (facial nerve preserved) £12,000–£19,500
Submandibular gland excision £5,500–£9,500
Sublingual gland excision (intraoral) £3,800–£7,000
Minor salivary gland lesion excision £2,200–£4,500
Ultrasound + FNA cytology visit £450–£850

Prices vary by hospital, by the consultant, and by complexity.

The problem

The facial nerve runs through the parotid - the operation is planned around it.

Salivary gland surgery is where general ENT quietly under-delivers - no facial nerve monitoring, no proper cytology first, no honest scar conversation.

  • Cytology before theatre, not after

    Ultrasound-guided FNA changes the operation in a third of cases - extracapsular versus superficial, or a full total parotidectomy for malignancy. Skipping it costs you the right operation.

  • Facial nerve monitoring is standard, not optional

    Any surgeon operating on the parotid should use continuous nerve monitoring. We only work with those who do.

  • Frey syndrome deserves an honest number

    Gustatory sweating affects up to a third of parotidectomy patients. It is treatable, but you need to know before consent - not discover it at three months.

When it helps

When removal of salivary gland lumps is the right step.

The situations we see most, plus the one red flag that means treating something else first.

  • Slow-growing lump in the parotid

    The commonest presentation - a painless lump in front of or below the ear. Most are benign pleomorphic adenomas.

  • Firm lump in the submandibular triangle

    A lump beneath the jaw - often a benign tumour but requiring cytology to exclude malignancy or Warthin.

  • Recurrent salivary swelling

    Painful gland swelling around meals, often with a palpable stone - sialolithiasis needing removal, sometimes with the gland.

  • Sudden facial weakness

    Any facial weakness with a salivary mass is a red flag for malignancy - needs urgent MRI, cytology and MDT review, not routine referral.

  • Recurrent pleomorphic adenoma

    A lump returning after prior enucleation - complex re-do surgery with a higher nerve-injury risk and a lower cure rate.

  • Warthin tumour (adenolymphoma)

    Benign, often bilateral, strongly associated with smoking - watchful waiting or targeted excision depending on symptoms.

  • Suspected malignancy on cytology

    Mucoepidermoid, adenoid cystic and adenocarcinoma - needs total parotidectomy, MDT-planned neck management and often adjuvant radiotherapy.

  • Red flag: rapid growth, pain or nerve palsy

    A fast-growing painful lump with facial nerve weakness needs a two-week-wait head-and-neck referral, not a routine outpatient booking.

Operation options

Approach and extent depend on the gland, the cytology and the position.

The eight commonest operations across the four salivary gland groups - what each involves and when it fits.

  • Extracapsular dissection

    For small, benign, mobile parotid tumours away from the facial nerve. Less nerve exposure, faster recovery, slightly higher recurrence than superficial parotidectomy.

  • Superficial parotidectomy

    Removal of the parotid tissue superficial to the facial nerve, with the tumour. The workhorse for pleomorphic adenoma and Warthin. Facial nerve preserved.

  • Total parotidectomy

    Superficial and deep lobes removed. For deep-lobe tumours and malignancies. Facial nerve preserved wherever oncologically safe.

  • Radical parotidectomy

    Total parotidectomy with sacrifice of the facial nerve. Reserved for aggressive malignancy invading the nerve. Immediate nerve grafting is planned.

  • Submandibular gland excision

    A submandibular skin-crease incision, with care to protect the marginal mandibular, lingual and hypoglossal nerves.

  • Sublingual gland excision

    Intraoral approach for ranula, mucocoele or tumour. Care for the lingual nerve and submandibular duct.

  • Minor salivary gland excision

    Targeted excision of a mucocoele or minor gland tumour from the lip, palate or floor of mouth - often day-case under local or GA.

  • Sialoendoscopy and gland-preserving surgery

    For sialolithiasis or duct stricture - endoscopic stone retrieval and duct dilatation preserving the gland. Not appropriate for tumours.

Safety and recovery

What to expect afterwards - honestly.

A well-established treatment. The things worth planning are the approach, the recovery, and knowing the honest risks.

  • GA in a specialist head-and-neck theatre

    General anaesthesia with a neuromuscular relaxant used briefly at induction, then avoided so facial nerve monitoring works throughout the case.

  • Temporary facial weakness

    Occurs in around 15–30 percent of parotid operations. Most recover within 6–12 weeks. Nerve monitoring keeps permanent weakness under 3 percent.

  • Frey syndrome (gustatory sweating)

    Sweating and flushing on the cheek when eating - up to a third of parotidectomy patients. Treatable with botulinum toxin. Named honestly before consent.

  • Salivary fistula and sialocoele

    A collection of saliva under the wound in the first two weeks - usually settles with aspiration and pressure. Under 5 percent need surgical revision.

  • Numb ear lobe

    The great auricular nerve is often divided in parotid surgery, leaving a numb lower ear. Usually improves over months; some patients have permanent numbness.

  • Marginal mandibular and lingual nerve injury

    A specific risk in submandibular surgery - asymmetric smile or altered tongue sensation. Careful subplatysmal dissection keeps this uncommon.

  • Infection, bleeding and haematoma

    Wound infection under 2 percent, haematoma under 3 percent. A small drain overnight reduces both. Any expanding swelling in the first 24 hours needs same-day contact.

  • Recurrence of pleomorphic adenoma

    Enucleation has recurrence rates over 20 percent long-term; superficial parotidectomy under 2 percent.

  • Red flags after surgery

    Expanding swelling, spreading redness, fever, worsening facial weakness or salivary leak through the wound need the same-day team, not a routine call.

Reading your notes

Your operation note in four parts. Read the last one first.

Whichever gland was operated on, and whichever extent was needed, the note the surgeon sends you keeps to the same shape.

A UK consultant head-and-neck surgeon reviewing a parotid ultrasound

A quiet reminder

Clinical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the notes before your review, just ask.

  1. 01 Header

    Gland, extent and facial nerve

    Which gland, which extent (extracapsular, superficial, total, radical), and the intraoperative facial nerve findings.

  2. 02 Technique

    Incision, drain and nerves preserved

    The incision used, whether a drain was left, and which nerves were identified and protected - facial, great auricular, marginal mandibular, lingual, hypoglossal.

  3. 03 Findings

    Histology and margins

    What the pathologist reported on the removed tissue - benign or malignant, subtype, and whether resection margins are clear.

  4. 04 Impression

    Adjuvant plan and surveillance

    Read this first: whether radiotherapy or a neck dissection is needed, the recurrence surveillance schedule, and any nerve-recovery plan.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Salivary gland surgery is usually covered when medically indicated. Ultrasound, cytology and histology are routinely included. Botulinum toxin for Frey syndrome may require separate pre-authorisation.

Frequently asked

Everything we get asked about removal of salivary gland lumps.

Quick answers on the facial nerve, scar, Frey syndrome, cost and recovery.

  • Will I have facial weakness after parotid surgery?

    Temporary weakness of one or more branches of the facial nerve occurs in about 15–30 percent of parotidectomies and almost always recovers within six to twelve weeks. Weakness after any parotid operation must be reported the same day so the team can review it.

  • What scar will I have?

    Parotid surgery uses either a modified Blair incision (in front of and behind the ear, extending under the jaw) or a facelift incision (hidden in the hairline and behind the ear). Submandibular surgery uses a skin-crease incision two fingers below the jaw. Sublingual and minor gland surgery are intraoral with no visible scar. We show you the exact position at consent.

  • What is Frey syndrome?

    Gustatory sweating - sweating and flushing on the cheek when eating - is a well-recognised late complication of parotid surgery, affecting up to a third of patients. It is caused by regenerating parasympathetic fibres joining sweat glands. It responds well to periodic botulinum toxin injections. We warn every patient about it before consent.

  • Is it always cancer?

    No. Around 80 percent of parotid tumours, 50 percent of submandibular tumours, and 50 percent of sublingual tumours are benign. Ultrasound-guided fine-needle aspiration cytology before surgery gives an accurate answer in most cases and determines the extent of operation planned.

  • How much does private salivary gland surgery cost in the UK?

    Roughly £6,500–£10,500 for extracapsular dissection, £8,500–£14,500 for superficial parotidectomy, £12,000–£19,500 for total parotidectomy, £5,500–£9,500 for submandibular excision, and £3,800–£7,000 for sublingual. A firm quote follows ultrasound and cytology results.

  • How long is recovery?

    Office work: 1–2 weeks. Driving: 1–2 weeks. Full activity and exercise: 4 weeks. The scar settles over 6–12 months. Follow-up with the consultant is at 6 weeks and - for benign tumours - at 6, 12, 24 and 60 months to catch any recurrence.

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