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Plastic Surgery

Oral Cancer Surgery & Reconstruction

Oral cancer encompasses malignancies arising in the lips, tongue, inner lining of the cheeks (buccal mucosa), gums (gingiva), floor of the mouth, and hard palate. It is among the most prevalent cancers in India, driven largely by the widespread use of tobacco in its various forms — smoking, chewing tobacco, gutka, and betel quid — as well as excessive alcohol consumption, HPV infection, and chronic sun exposure (particularly for lip cancers). Warning signs include a non-healing ulcer or sore in the mouth lasting more than two to three weeks, a persistent lump or thickening, white or red patches (leukoplakia or erythroplakia), difficulty chewing or swallowing, numbness in the tongue or lip, unexplained bleeding, chronic sore throat, ear pain, and noticeable weight loss.

Diagnosis begins with a thorough clinical examination and biopsy of suspicious lesions, followed by imaging studies — including X-rays, CT scans, MRI, PET scans, and endoscopy — to determine the extent and stage of the disease. Oral cancer is staged from I through IV, with survival rates strongly correlated with early detection: the one-year relative survival rate is approximately 81%, while the five-year rate is around 56%, underscoring the critical importance of early diagnosis and prompt treatment.

Dr. Amit Agrawal at Amit Aesthetics in Aligarh provides comprehensive surgical management of oral cancer, from wide local excision of early-stage tumors to complex composite resections involving the jaw bone, neck dissection for lymph node metastasis, and immediate reconstruction using microvascular free flaps to restore form and function. His approach as a plastic surgeon ensures that oncological adequacy — complete tumor removal — is achieved while simultaneously planning the reconstruction needed to preserve the patient's ability to speak, eat, and maintain facial appearance.

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Procedures & Techniques

  • Wide local excision of oral tumors
  • Glossectomy (partial or total tongue excision)
  • Mandibulectomy (partial jaw resection) with reconstruction
  • Maxillectomy for palate and upper jaw tumors
  • Modified radical neck dissection for lymph node involvement
  • Reconstruction with pedicled flaps (pectoralis major, nasolabial)
  • Microvascular free flap reconstruction (fibula, radial forearm, ALT)
  • Dental and prosthetic rehabilitation planning
  • Surgical management of lip cancer with reconstruction

Recovery & Aftercare

Recovery after oral cancer surgery depends on the extent of the procedure. Minor excisions of early-stage tumors may heal within two to three weeks with minimal functional impact. Extensive resections involving the jaw or tongue, with free flap reconstruction, require a hospital stay of seven to fourteen days, with a tracheostomy and nasogastric feeding tube in the initial post-operative period. Speech and swallowing therapy begins within days of surgery and continues for several weeks to months. Patients undergoing neck dissection may experience temporary shoulder stiffness requiring physiotherapy. Follow-up includes regular surveillance with clinical examinations and imaging every three to six months for the first two years, then annually thereafter. Adjuvant radiation or chemotherapy may be required based on the final pathology report.

Frequently Asked Questions

What are the early warning signs of oral cancer?
Key warning signs include a mouth ulcer or sore that does not heal within two to three weeks, a persistent lump or thickening in the cheek or neck, white or red patches on the gums, tongue, or lining of the mouth, difficulty or pain when chewing or swallowing, unexplained numbness or bleeding in the mouth, chronic sore throat, and a change in voice. Anyone experiencing these symptoms — particularly tobacco or alcohol users — should seek immediate medical evaluation.
Will I be able to speak and eat normally after oral cancer surgery?
The impact on speech and eating depends on the location and extent of the tumor. Early-stage cancers requiring limited excision often have minimal long-term functional impact. More extensive surgeries involving the tongue, jaw, or palate are followed by immediate reconstruction and dedicated speech and swallowing rehabilitation. Most patients achieve functional speech and adequate oral intake, though the degree of recovery varies. Prosthetic devices such as obturators can also help restore palate function after maxillectomy.
How is the jaw reconstructed after tumor removal?
When a portion of the jaw (mandible) must be removed to achieve complete tumor clearance, it is typically reconstructed in the same surgical sitting using a microvascular free flap — most commonly the fibula free flap, where a segment of the leg bone along with its blood supply is transferred and shaped to recreate the jaw contour. A titanium reconstruction plate provides additional structural support. This approach restores facial form, supports future dental implant placement, and enables recovery of chewing function.
What follow-up is required after oral cancer treatment?
Long-term surveillance is critical after oral cancer treatment due to the risk of recurrence and second primary tumors. Follow-up typically involves clinical examinations every one to three months for the first two years, every four to six months for years three through five, and annually thereafter. Imaging studies (CT, MRI, or PET) are performed as indicated. Patients are also counseled strongly on tobacco and alcohol cessation, as continued use significantly increases the risk of recurrence.

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