Reconstruction Surgery
Dr. Satish Rao, a surgical oncologist, offers reconstruction in head and neck cancer in Mumbai.
Overview
Reconstruction in head and neck cancers is a specialised area of surgical oncology focused on restoring form and function after tumour removal. When cancer surgery removes significant tissue, skin, muscle, bone, or a combination, reconstruction is used to rebuild what was removed, with the aim of supporting speech, swallowing, chewing, and appearance. Techniques range from local tissue rearrangement to complex microsurgical free flap procedures that transplant tissue from another part of the body. Multidisciplinary surgical planning is part of reconstruction.
What Is Reconstruction in Head and Neck Cancers?
Head and neck reconstruction refers to the surgical restoration of anatomical structures, the jaw, tongue, cheek, floor of mouth, throat, or skin, after their removal as part of cancer treatment. The head and neck region is involved in basic functions such as eating, breathing, speaking, and facial expression. Reconstruction focuses on restoring form and function. It is planned together with tumour resection and can be performed in the same operation.
What Are the Signs That Reconstruction Is Needed?
Reconstruction is indicated whenever cancer surgery creates a defect that compromises function or significantly alters appearance. Common clinical indicators include:
- 1. A lump, ulcer, or mass in the jaw, cheek, tongue, or neck requiring surgical removal
- 2. Bone involvement of the mandible (lower jaw) or maxilla (upper jaw) necessitating partial resection
- 3. Large soft tissue defects of the tongue, cheek lining, or floor of mouth after excision
- 4. Skin or external soft tissue loss following removal of infiltrating tumours
- 5. Throat or pharyngeal defects following laryngeal or hypopharyngeal cancer resection
- 6. Loss of facial structure or contour following parotid or salivary gland cancer surgery
Any patient undergoing major head and neck cancer resection should have a reconstruction plan established before surgery begins.
What is Oncoplastic Reconstruction in Breast Cancer ?
Oncoplastic reconstruction is a surgical approach that combines cancer removal with immediate reshaping of the remaining breast tissue, with the aim of preserving the shape of the breast after tumour excision. Oncoplastic surgery addresses cancer removal and breast shape in a single operation. Techniques such as volume displacement (redistributing existing breast tissue) and volume replacement (adding tissue from elsewhere) are chosen based on tumour size, location, and the patient’s body type.
What Are Microvascular and Regional Flaps in Breast Reconstruction?
Microvascular and regional flap reconstruction rebuilds the breast using the patient’s own tissue transferred from another part of the body. Regional flaps, such as the latissimus dorsi flap from the back, use nearby muscle and skin with their blood supply intact. Microvascular free flaps, including the DIEP (deep inferior epigastric perforator) flap from the abdomen, are completely detached and reattached to blood vessels in the chest using microsurgical techniques under magnification. These approaches are options for patients who prefer to avoid implants or who require complex reconstruction after mastectomy.
Multidisciplinary Treatment Approach
Treatment plans for head and neck cancer can include surgery, with coordination of radiation therapy and chemotherapy.
Risks and Limitations of Reconstruction
Reconstruction is planned according to the site and extent of tissue removed and the patient’s general health. The choice of technique varies from patient to patient, and not every technique is suitable for every patient. As with any major surgical procedure, reconstruction can involve risks such as bleeding, infection, delayed wound healing, scarring, and reactions to anaesthesia. Free flap procedures depend on blood vessel connections, and the transferred tissue can have a reduced blood supply or fail to survive, which may require further surgery. The area from which tissue is taken can also be affected, with pain, weakness, or scarring.
Speech, swallowing, chewing, and appearance can be affected temporarily or for a longer period after head and neck surgery. Rehabilitation or additional procedures may be needed. In breast reconstruction, changes in breast shape, symmetry, or sensation can occur. Results vary from patient to patient.
Appointments and Contact Details
To schedule a consultation with Dr. Satish Rao, contact the clinic by phone, email or WhatsApp. For your first consultation, please bring any prior reports, scans and prescriptions, along with a list of your current medications.
