I have recovered very well from the reconstruction of my mandible with the fibula free flap. My mouth is better aligned with my chin in line with the center of my face. My speech is almost perfect. I am still having some slight pains in my ankle, swelling on top of the foot and use a cane if I am walking on an uneven surface or for a long distance. I tire easily and my hemoglobin count is low which the internist attributes to the medical trauma of the past 5 years. It is now almost 3 months after surgery and I see daily improvement.

After consulting with the top oral surgeon and prosthodontist, who are both the most experienced with oncology patients here, I have decided not to have dental reconstruction.

It seems that my fibula was not thick enough to build up as much as the prosthodontist recommended (I have very small, child sized bones) and the oral surgeon felt that there was not enough to support implants. He recommended removing 5 teeth, spacing implants in the original bone and having a prosthesis on top of that.

I saw the prosthodontist today who said that he would not recommend this for me for several reasons. It would involve the removal of healthy teeth for a procedure which may not be successful. I would be without the majority of my lower teeth for several months and although he would make a temporary prosthesis until everything healed, it would not be a comfortable or effective and I would be unhappy with it. He said that if he were my son he would say don't do it. It is not medically necesssary particularly given all I have been through and my age, I could be in the 5% failure group, cosmetic effects are unimportant to me, and it is very expensive. He again said that if I were his mother he would say not to risk it.

I thank all of you who have been supportive of me since I first came "on board" about a year and 1/2 ago researching mandibular reconstruction.
Malka