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#192486 05-30-2016 08:30 PM
Joined: Jul 2015
Posts: 6
"OCF Down Under, Kiwi"
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"OCF Down Under, Kiwi"
Member

Joined: Jul 2015
Posts: 6
I am considering my second fibula free flap surgery to reconstruct my mid face. The first surgery (2014) was successful, however, due to the positioning of the bone there is insufficient bone for implants, and no dentition for dentures. I have 8 teeth missing from my right upper jaw and no dental options.

I could accept this situation, and choose soft tissue transfer, some further adjustments to my mid face, including a half face lift, the use of fat injections and botox to reconstruct my face...or

I could undergo another ffft and then do all of the above. The difference would be eight teeth.

What do you think? What should I weigh up?



Adenoid cystic carcinoma - right maxilla
24.09.14 Right maxillectomy
08.12.14 Reconstruction of maxillary defect with left fibula free flap.
23.12.14 Endoscopic medial maxillectomy.
31.03.15 Completion of IMRT, 60 Gy 30 fractions.
24.08.15 Secondary reconstruction of right mid face, utilising right radial forearm free flap.

Happy :-)
Joined: Jun 2007
Posts: 10,507
Likes: 6
Administrator, Director of Patient Support Services
Patient Advocate (old timer, 2000 posts)
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Administrator, Director of Patient Support Services
Patient Advocate (old timer, 2000 posts)

Joined: Jun 2007
Posts: 10,507
Likes: 6
I completely understand why you would want to redo the major surgery. Please proceed with caution! You have had radiation to the area where you are looking to have surgery on. This comes with significant risk to the 2nd surgery not heeling properly or even worse... failing. Have you discussed this with a physician who knows your complete medical history? If so and they did not bring up the dangers of surgery on a radiated area then you need to get at the very least another opinion. Whatever you decide I wish you all the very best, just please choose wisely.

Ive been approached by doctors about "fixing" the end result of my 2009 surgery. In my situation, I had a very hard time with the original mandibulectomy failing and having to be redone only 2 weeks later. Then it was heeling problems with 8 months of picc line refrigerated antibiotics 3x a day, weekly wound care appointments, a visiting nurse once or twice a week, plus wayyy too many HBO to count. Thinking of all that I went thru plus how slim my survival odds were and I choose to not take the risk.

Good luck!!!


PS...
Ask your doc and please let us know what the doc says.....

What impact radiation has on your heeling?

How long is the surgery?

Will the surgery be as involved as the original one?

What are the chances the surgery will fail?

What kinds of complications would I face if it fails?

How many of these types of surgeries do you preform per year?

Have you ever done this on a radiated patient?



Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
Joined: Oct 2013
Posts: 58
Supporting Member (50+ posts)
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Supporting Member (50+ posts)

Joined: Oct 2013
Posts: 58
I personally had my 2nd fibula free flap 2 years after my first surgery after radiation and after chemo. I am very happy with my results. Prior to the 2nd surgery I had an infection that lasted from 11/2013 until 1/2016. My only side effect other then the recovery/ pain has been the donor site. I just wish that I hadn't waited so long. Please discuss everything with your doctors. While everyday remains a challenge I am so thankful for being here to be able to "complain". Good luck and best wishes.


8/2013 dx sarcoma lft mandible 10/22/2013 fibula free flap with mandiblectomy, peg,tracheotomy, 11/8/13 trach removal, 2nd mandible sx 12/13, 35 IMRT 1/2014.4/2014 chemo x6 only tolerated 3. (Seizures) repeat fibula free flap 1/2016

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