Head & Neck Reconstruction Surgery in Chennai

A free flap is tissue (skin, muscle, bone, or combination) transferred from one part of your body to reconstruct defects after cancer surgery. "Free" means the tissue is completely detached from its original blood supply and reconnected to blood vessels at the recipient site using microsurgery. This allows transfer of living tissue over long distances with reliable blood supply for healing.

Common donor sites include: fibula (leg bone) for jaw reconstruction with dental implants; radial forearm for thin, pliable tissue for tongue and throat; anterolateral thigh (ALT) for larger soft tissue needs; and rectus abdominis (abdomen) for bulk reconstruction. Dr. Vidhyadharan selects the donor site based on reconstruction needs and minimizing donor site problems.

Yes, harvesting tissue for free flap reconstruction creates a scar at the donor site. For radial forearm flaps, a skin graft covers the forearm. For fibula flaps, a scar runs along the outer leg. For thigh flaps, a scar is hidden on the outer thigh. Donor site scars typically heal well and are considered an acceptable trade-off for successful reconstruction.

Most patients achieve good eating and speaking function after jaw reconstruction, especially with dental rehabilitation. Fibula free flaps allow placement of dental implants 6-12 months later, restoring chewing ability. Speech therapy helps optimize articulation. While some adaptation is needed, most patients return to social eating and clear communication.

3D virtual surgical planning uses CT scans to create a computer model of your anatomy. Surgeons plan bone cuts, flap shaping, and implant positions on the computer before surgery. Custom cutting guides are 3D-printed to execute the plan precisely during surgery. This technology improves accuracy, reduces surgery time, and enhances functional and cosmetic outcomes.

Combined cancer removal and free flap reconstruction typically takes 8-14 hours depending on complexity. Two surgical teams work simultaneously to minimize total time. Despite the length, this single surgery approach is preferred over staged procedures as it reduces overall treatment time and achieves immediate reconstruction.

The main risk is flap failure (1-5%) if blood supply is compromised, requiring urgent return to surgery. Other risks include wound infection, hematoma, donor site problems, and need for additional procedures. Close ICU monitoring in the first 48-72 hours allows early detection and management of complications. Success rates exceed 95% in experienced hands.

Yes, reconstruction can be performed before or after radiation. Immediate reconstruction at the time of cancer surgery is preferred when possible. If radiation is needed afterward, healing occurs before radiation starts. For patients who have already had radiation, free flap reconstruction brings healthy, non-radiated tissue to the area, improving healing.

Dental implants are typically placed 6-12 months after fibula free flap reconstruction, once the bone has healed and integrated. This timing allows for any adjuvant treatment (radiation) to complete. Implant-supported dentures or fixed teeth can then be placed, restoring chewing function and facial appearance.

Hospital stay is typically 7-14 days. Initial swelling resolves over 4-6 weeks. Return to soft diet in 2-3 weeks, regular diet in 6-8 weeks depending on reconstruction type. Complete healing and functional rehabilitation takes 3-6 months. Dental implants and prosthetic work add additional time but restore full function.

Modern reconstruction techniques restore facial contour and symmetry effectively. While some difference from pre-cancer appearance is expected, most patients are satisfied with cosmetic outcomes. Jaw reconstruction with dental implants restores lower face shape. Soft tissue flaps restore oral and facial contour. Goal is returning patients to confident social interaction.

Reconstruction costs vary significantly based on type of flap used, complexity of defect, need for 3D planning and custom guides, ICU duration, hospital stay, and rehabilitation needs. Free flap surgery requires specialized microsurgical expertise and equipment. THANC Hospital and Dr. Vidhyadharan provide world-class reconstruction at economical costs compared to other centers. Detailed estimates are provided during consultation.