Advanced Reconstruction

Understanding Head and Neck Reconstruction

Head and neck reconstruction is a specialized field of surgery focused on restoring both form and function after cancer removal. When treating head and neck cancers, our primary goal is complete removal of the cancer. However, this often requires removing significant portions of tissue, bone, or structures that are essential for normal appearance and function.

Advanced reconstruction techniques allow us to rebuild these critical structures, helping patients regain their ability to speak, eat, breathe normally, and maintain facial appearance. At Premier Head and Neck Surgery, we employ state-of-the-art reconstructive approaches that have revolutionized outcomes for head and neck cancer patients.

The need for reconstruction depends on several factors, including:

The size and location of the tumor
The extent of surgical resection required
The specific structures affected (bone, soft tissue, nerves, etc.)
The patient’s overall health and functional needs
Long-term quality of life considerations

Reconstructive Techniques

At Premier Head and Neck Surgery, we offer a comprehensive range of reconstructive techniques, from relatively simple procedures to highly complex reconstructions:

Local and Regional Flaps

For smaller defects, we may use nearby tissue to reconstruct the affected area. These flaps involve moving adjacent healthy tissue with its blood supply to fill the defect created by tumor removal. Examples include:

Facial rotation flaps for cheek or lip reconstruction
Pectoralis major flaps for neck or lower face reconstruction
Temporalis muscle flaps for oral cavity reconstruction

Microvascular Free Tissue Transfer

For larger or more complex defects, we specialize in microvascular free tissue transfer (free flaps), the gold standard in head and neck reconstruction. This advanced technique involves:

Harvesting tissue (skin, muscle, bone, or combinations) from a distant part of the body, such as the forearm, thigh, or lower leg
Completely detaching this tissue with its blood vessels
Transferring it to the head and neck region
Reconnecting the blood vessels using microsurgical techniques to establish blood flow
Shaping and securing the tissue to reconstruct the defect

Common free flaps used in head and neck reconstruction include:

Radial forearm free flap: Ideal for lining the mouth, tongue, or throat
Fibula free flap: Used for jaw reconstruction, allowing for dental implants
Anterolateral thigh flap: Versatile for larger soft tissue defects
Scapular/parascapular flap: Useful for complex three-dimensional defects

Jaw Reconstruction with Microvascular Flaps

Jaw (mandible or maxilla) reconstruction represents one of the most challenging aspects of head and neck reconstruction. When cancer affects the jawbone, significant portions may need to be removed, affecting facial appearance, speech, and the ability to chew.

Our surgeons specialize in vascularized bone flaps, particularly the fibula free flap, which allows us to:

Harvest a portion of the fibula bone (which doesn’t affect leg function)
Shape it to match the contour of the missing jawbone
Include skin and soft tissue when needed
Provide a foundation for dental implants
Restore both function and appearance

This technique has transformed jaw reconstruction, allowing patients to maintain facial contour and often return to normal eating and speaking.

Facial Reconstructive Surgery

When cancer affects the face, reconstruction must address both functional and aesthetic concerns. Our facial reconstructive techniques include:

Nasal reconstruction for defects after removal of nasal or sinus tumors
Orbital reconstruction to maintain eye function and appearance
Lip and oral commissure reconstruction to preserve speech and prevent drooling
Facial reanimation procedures to restore movement after nerve damage

Computer-Assisted Planning and 3D Printing

We employ advanced technology to optimize reconstructive outcomes:

Virtual surgical planning using CT and MRI imaging
Computer-generated cutting guides for precise bone shaping
3D-printed models for preoperative planning
Custom implants for specific reconstructive needs

These technologies allow for more precise reconstruction, shorter operating times, and improved functional and aesthetic outcomes.

Benefits of Advanced Reconstruction

Patients who undergo advanced reconstruction at Premier Head and Neck Surgery experience numerous benefits:

Improved ability to speak, eat, and breathe
Better facial appearance and symmetry
Enhanced quality of life and psychological well-being
Potential for dental rehabilitation with implants
Single-stage reconstruction that reduces overall recovery time
Preservation of function while ensuring complete cancer removal

Our reconstructive approach is tailored to each patient’s specific needs, with the goal of restoring both form and function to the highest possible degree.

Benefits of Advanced Reconstruction

Patients who undergo advanced reconstruction at Premier Head and Neck Surgery experience numerous benefits:

Improved ability to speak, eat, and breathe
Better facial appearance and symmetry
Enhanced quality of life and psychological well-being
Potential for dental rehabilitation with implants
Single-stage reconstruction that reduces overall recovery time
Preservation of function while ensuring complete cancer removal

Our reconstructive approach is tailored to each patient’s specific needs, with the goal of restoring both form and function to the highest possible degree.