Removing tumors, affected tissues, and other structures is sometimes necessary to effectively treat head and neck cancers. However, even necessary removal can produce issues with function and appearance. Complex head and neck reconstructive surgery rebuild defects in the neck or face that result from initial surgery to remove harmful tissues.

Why is oncoplastic reconstructive surgery performed for the head and neck?

This surgery aims to restore function, appearance, and personal comfort to those undergoing head and neck cancer treatment. Oncoplastic surgery for the head and neck improves the appearance and function of the following:

  • Face
  • Skull
  • Jaws
  • Ears

Surgery may also be necessary when wounds do not heal as expected or following treatment for malignant or benign tumors affecting the following:

  • Mouth and adjacent oral cavity
  • Salivary glands
  • Tongue
  • Larynx
  • Pharynx
  • Jaw
  • Sinuses

What to Expect Before and during oncoplastic reconstructive surgery for head and neck

The Ariel Center surgical team will prepare you with information regarding what you can and can’t do before reconstructive surgery. This includes information about eating, drinking, and taking medication. Adhering to these instructions will minimize some risks associated with oncoplastic surgery and ensure optimal results.

Your care team can also tell you what to expect during your recovery and which types of services you may need to help you regain lost functions post-op. Examples include physical, speech, or occupational therapy.

Many procedures involve tissues, muscles, skin, and blood vessels from other body parts. Grafts or flaps are transferred from the donation site to the affected area.

A skin graft procedure transfers a patch of healthy skin to another location on the body to cover the large wound or area with missing or damaged skin. An example is how a split-thickness graft involves layers of skin close to the surface, while a full-thickness graft uses all layers for minor facial defects. A composite skin graft uses fat tissues and underlying cartilage for wounds and imperfections with a complex shape.

Alternatively, tissue and blood vessels may be transferred from one part of the body to the affected part of the head or neck. These “flaps” can be either local or regional: a local flap uses skin close to the defect or wound, while a regional flap is transferred with a blood vessel attached from the original site.

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Microvascular reconstruction moves tissue from body parts away from the transfer site and reconnects the blood supply at the new site. An example of this would be how:

  • If the skull base needs to be reconstructed, abdominal or back muscles may be used as part of free muscle transfer.
  • For upper jaw or mid-face reconstruction, part of a rib or calf bone is used
  • The tongue, head, neck or neck skin, nasal lining, or pharynx may be corrected with tissues from a forearm or thigh

Head and neck reconstructive surgery is exceedingly complex; as such, it generally follows healing from the initial surgery that removed the problem growth. Reconstruction surgery may be divided into more minor procedures, and Dr. Rancati may perform additional cosmetic procedures.

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Risks & Recovery

All surgical procedures carry some risks. For oncoplastic reconstructive surgery for the head and neck, consider the following risks:

  • A temporary tracheotomy is sometimes necessary for maintaining breathing capabilities during reconstruction
  • Infections at the incision sites
  • Blood clots
  • Complications associated with anesthesia

Your downtime, recovery, and rehabilitation needs may vary based on the extent of your head and neck surgery. Minor reconstruction, such as a local flap procedure, may only require a couple of days in the hospital, while more extensive surgery requires a longer hospital stay and extended recovery.

You must know that after surgery, you won’t face recovery alone. Our clinical staff is here to return every phone call and answer every question if complications develop during recovery. Dr. Rancati can tell you when to expect swelling and bruising to subside and answer your questions if something is unclear or doesn’t look or feel right.

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