Treating cancers of the face, head and neck can lead to functional and cosmetic side effects that sometimes require advanced reconstructive surgery. Our collaborative team approach helps us tailor treatment options for each patient.
In cases where patients need reconstructive surgery, our goal is to restore appearance and function to preserve our patient’s quality of life. Head and neck surgical oncology and reconstructive specialists, along with our plastic surgery team members, work together to ensure that the removal of the cancer and the reconstruction are seamless and successful. Through our extensive experience and expertise, we understand the subtleties and complexities of how different treatment approaches affect our patients and their function, quality of life and appearance.
We always strive for curative treatment options, yet are also committed to making quality of life a priority for our patients during and after these interventions. Focusing on our patient’s reconstructive needs after advanced surgical resections of tumors is part of this commitment.
Microvascular Reconstruction Surgery
In some situations, tissue from a patient’s own body outside of the head and neck region is "transplanted" to reconstruct areas of the face, mouth, throat or neck. This type of procedure is often referred to as microvascular reconstruction surgery (also known as "free flap" or "free tissue transfer" surgery).
These types of procedures are highly complex and require intricate and highly specialized techniques to address the very visible and functionally complex regions of the head and neck. During these procedures, surgeons use specialized instruments and a microscope to guide them as they make repairs and attach delicate structures such as the blood vessels and nerves of transplanted tissues. This technique can be cosmetically and functionally superior to other, simpler reconstructive options.
Our head and neck cancer and reconstruction surgeons often collaborate within our multidisciplinary team to offer a single-surgery approach to head and neck cancer procedures that require advanced reconstruction. In these carefully orchestrated surgeries, one surgical team removes the tumor while a second surgical team removes tissue from another area of the body to use in repairing the surgical site.
The goal is to make the process easier on the patient by decreasing the time under anesthesia and avoiding additional recovery time. We are proud to be one of the only facilities in the state offering this simultaneous approach for these highly complex procedures.
Reconstructive Surgery for Head and Neck Cancer - Video FAQ
Michael Stadler, MD, head and neck surgical oncologist, explains skin cancer reconstruction.
Skin cancer reconstruction refers to the surgical steps that we take to promote healing as well as cosmesis, or appearance, after a skin cancer is removed.
Michael Stadler, MD, head and neck surgical oncologist, explains the importance of skin cancer reconstruction.
Because of the visible nature of head and neck and scalp skin cancers, skin cancer reconstruction is very important to a patient's quality of life, as well as their self-image. Therefore, we take every step and make every effort to address this because it is important to our patients.
Becky Massey, MD, head and neck surgical oncologist, explains when reconstruction is needed during head and neck cancer surgery.
Reconstructive surgery is often needed for head and neck surgery. It is important to have the structures in the mouth and throat be separate from one another, so they can move normally. Whenever we remove a significant amount of tissue from the mouth or the throat, we have to put something back so the tissues do not scar together.
Michael Stadler, MD, head and neck surgical oncologist, describes how we replace tissue lost during the removal of head, neck and scalp skin cancer.
After skin cancer surgery of the scalp, head or neck, we follow basic principles of replacing lost tissue that we have to remove related to the skin cancer. That can be as simple as closing incisions directly.
Due to the very cosmetic and highly visible nature of these areas, we may need to rearrange skin and replace lost tissue with skin immediately available from that head, neck and scalp region. If that is not possible, we may have to borrow skin from another part of the body to reconstruct these highly visible regions.
Jennifer Bruening, MD, surgical oncologist, describes free flap reconstruction surgery.
Free flap reconstruction surgery is an advanced technique to repair defects after your cancer surgery. We borrow tissue from a distant site — such as your arm, your leg, your stomach or the back — along with its blood supply (an artery and a vein). We transfer this into the head and neck, using a microscope to connect the artery and the vein to the vessels in the neck. The flap portion of the surgery takes the tissue, so that can consist of skin and fat — or even muscle and bone.
Jennifer Bruening, MD, surgical oncologist, explains what is repaired with free flap reconstruction surgery.
Free flap reconstructive surgery is used for reconstructing large defects after surgery or a large trauma. We particularly use it after head and neck cancer surgery when there is a large defect or hole, and there is not enough tissue nearby to fill in the space.
Jennifer Bruening, MD, surgical oncologist, explains the healing process for the incision from free flap surgery.
In general, the incisions take about one to two weeks to seal. It can take many months for the swelling in the flap and the tissues around it to settle down and start to look normal.
Jennifer Bruening, MD, surgical oncologist, describes the benefits of free flap reconstruction surgery for head and neck cancer patients.
Free flap reconstructive surgery can repair very large surgical defects. It also restores critical functions in that area — such as speaking, swallowing, facial motion and, most importantly, breathing.
Jennifer Bruening, MD, surgical oncologist, explains what a patient can expect before free flap surgery.
Before free flap surgery, patients can expect to meet multiple members of the team that's going to be taking care of them. This can include the cancer surgeon, the reconstructive surgeon and the anesthesia team, as well as some of the support staff, such as speech and swallowing therapists.
There are additional tests that we may order to make sure we choose the adequate flap. For surgical planning, we may need additional imaging, such as an MRI or a CT scan.
Jennifer Bruening, MD, surgical oncologist, explains what a patient can expect after free flap surgery.
After free flap surgery, you can expect to be in the hospital anywhere from five to 10 days — longer if there are complications. During that period of time, we keep a very close eye on the flap. We monitor the blood flow and the appearance of the flap.
After you go home, we will have you come back to our office frequently just to ensure that everything is healing correctly.
Virtual Visits Are Available
Safe and convenient virtual visits by video let you get the care you need via a mobile device, tablet or computer wherever you are. We’ll gather your medical records for you and get our experts’ input so we can offer treatment options without an in-person visit. To schedule a virtual visit, call 1-866-680-0505.
Cancer and the COVID-19 Vaccine
There is currently no data that suggests current or former cancer patients should avoid getting the COVID-19 vaccine. Cancer can weaken your immune system, so we recommend that most patients get the vaccine as soon as possible.