Restoring function, appearance, and quality of life for patients who were not reconstructed at initial surgery — or whose reconstruction needs revision.
Who This Page Is For
Many patients treated for oral cancer — sometimes years ago — are left with significant functional or cosmetic deficits that were never addressed. Secondary reconstruction can change that.
Jaw removed but not rebuilt. Tongue or cheek resected without flap repair. Patients left with significant defects after cancer surgery at another centre.
Initial free flap or pedicled flap did not survive — resulting in an unhealed wound or collapsed reconstruction requiring a new flap from a different donor site.
Flap is healed but bulky, poorly contoured, or functionally inadequate — causing problems with speech, chewing, mouth opening, or appearance.
Osteoradionecrosis of the jaw, radiation fibrosis, wound breakdown, or fistula formation requiring reconstructive surgery after radiation therapy.
Reconstructive Options
Why This Requires Specialist Expertise
Secondary reconstruction is technically more demanding than primary reconstruction. Scar tissue, radiation changes, and altered anatomy all increase complexity — making surgeon experience critical.
Previous surgery creates dense scar tissue that distorts anatomy, makes tissue planes difficult to identify, and reduces tissue compliance for reconstruction.
Post-radiation tissue has impaired healing capacity, reduced vascularity, and higher infection risk. Free-flap reconstruction brings well-vascularised tissue into a hostile field.
Neck vessels used for microvascular anastomosis may have been damaged by previous surgery or radiation — requiring careful vessel selection or vein grafting.
If one free flap has already been used, the same donor site may not be available — requiring a different flap design. Dr. Narayana is experienced with multiple donor site options.
Your Journey
Review of all prior surgery, radiation, and histopathology. Confirm there is no residual or recurrent cancer before planning reconstruction. PET-CT or MRI obtained if any concern.
Detailed assessment of the defect — size, tissue composition, missing structures. Functional priorities discussed: eating, speech, appearance, mouth opening. Realistic goals set collaboratively.
CT angiography of recipient neck vessels and donor site vessels to confirm suitability. Alternative donor sites identified if primary option unavailable.
Case discussed with radiation oncologist, oral maxillofacial surgeon, dental team, and speech therapist. Adjuncts such as hyperbaric oxygen considered for post-radiation cases.
Free-flap or regional flap reconstruction tailored to the defect. Simultaneous dental implant placement into fibula performed where appropriate. Duration 4–10 hours depending on complexity.
Speech therapy, physiotherapy, dietician support. Dental implant loading at 6–9 months. Ongoing follow-up for oncological surveillance and functional review.
Why Choose Dr. Narayana
Lead Consultant — Head & Neck Surgical Oncology & Skull Base Surgery, Bangalore
Frequently Asked Questions
Send your previous surgical notes, imaging, and photographs on WhatsApp — our team responds within 4 hours.
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