Hi everyone. I'm investigating appearance issues for my little group in New Zealand.

If there is some disfigurement which could be fixed by further plastic surgery, would your insurers fund it? Does your follow up care/survivorship care provide it or suggest it?

It seems that we have a shortfall here. Everyone goes all out to eliminate the cancer but further procedures to ensure an improved appearance and better function are not a priority.

After breast cancer, a reconstruction is provided. Is any similar reconstruction offered to oral cancer patients or is it just too difficult to do. I'm not really inquiring for myself but curiously, I saw a new surgeon recently for Botox. (I drool!) He mentioned as an aside that I could have some sort of "wedge" procedure on my limp lower lip to stop it receding so much on one side. That was never mentioned by my regular follow-up team.

Can anyone shed any light on this issue?

When I went thru my third round of OC in 2009 I had complications with the first mandibulectomy. My body rejected the titanium plate causing the transplanted skin to turn black and die. The titanium plate was removed and the mandibulectomy was redone 3 weeks after the first one. This left me permanently disfigured. Alpaca, I kinda think you may have seen my photos but Im not completely sure. One year later I was finally eligible to have reconstruction surgery to help fix the left side of my face and neck. This was 100% covered by my insurance. I even had some other surgery covered 100% as it was a direct result of the failed mandibulectomy. I'll PM you with those details. I hope this helps you.

Oh, no, I deleted my post! Thank you Christine. We are helping review the standards for head and neck cancer treatment in our local area in New Zealand. Wondering about plastic surgery/reconstruction and also dental prosthetics etc. We have a lovely little site in New Zealand now but I always refer to OCF when out of my depth because of the expertise and volume of people.

I know we do have members from NZ. I hoped you would get some replies. I gave it a couple days and saw you still hadnt gotten any feedback so I thought it cant hurt to give you some input from the US. Here our medical systems work in mysterious ways!!! What I explained here could turn out completely different if I had less insurance or far worse for the patient with no insurance. My input is in no way anything to do with the US politics (please no political feedback from anyone). I had excellent insurance due to the job I had. I had a union job with a major telcom company for many years so had top notch medical/dental insurance.

Hi Alpaca,

I saw your post a few days ago, which Christine pretty much covered for the U.S. aspect, and glad to see your involvement and information sharing in New Zealand.

I have been offered the lower lip "Wedge" surgery you mentioned, which condition you speak of was a result of my jaw nerve being cut from the segmental mandibulectomy I had last September, causing similar left lower lip numbness and paralysis. During this surgery, my ENT could also debulk my neck, which I inquired about, where the calf skin paddle is from surgery. I was supposed to have the wedge surgery after the holidays, but with my leg graft delayed in healing, and scheduled regraft surgery, in addition too, having neck fibrosis, lymphdemia, and being vessel depleted in my left neck as a result of numerous other neck dissections and radiation, 5x each lol, I figured I'll reconsider after the leg graft in April, which is being done by the plastic surgeon,

My Insurance, now medicare and a medicare supplemental plan, would cover this surgery. I did have what is considered reconstructive surgery during the mandibulectomy; a fibular free flap, which is pretty much standard now with late stage ORN surgery, which was covered by insurance also. There are a few other treatment/surgery related defects I haven't inquired about, and not sure if insurance would pay, being it's more aesthetic, but my concern is just wanting to avoid another surgery, but I would guess such may be covered by insurance if it's medically necessary.

Good luck