Coastal Plastic Surgery & Medi Spa — Erina NSW Head & Neck Reconstruction
Major head and neck cancer surgery can result in significant defects affecting appearance and function. Our specialist plastic surgeons work as part of a multidisciplinary team to restore anatomy and function using advanced free flap microsurgical reconstruction.
Restoring form and function after cancer treatment
Head and neck cancer reconstruction refers to the surgical restoration of anatomy and function following the removal of cancers in the head, face, mouth, jaw, throat, and neck. The location and extent of a tumour — and the surgery required to remove it — can cause significant defects that profoundly affect both appearance and vital functions including eating, speaking, breathing, and swallowing.
These are among the most complex procedures in reconstructive surgery, requiring microsurgical expertise to transplant composite tissues — including skin, muscle, nerve, and bone — from other parts of the body to the head and neck region. The goal is to restore as much normal anatomy and function as possible, while also achieving the best possible aesthetic outcome for the patient.
At Coastal Plastic Surgery, our specialist plastic surgeons have expertise and experience in the reconstruction of intraoral, facial, and craniofacial defects following head and neck cancer surgery.
Free tissue transfer (free flap surgery) involves surgically removing a section of tissue — which may include skin, fat, muscle, fascia, nerve, and sometimes bone — from a donor site elsewhere in the body. This tissue is transplanted to the head and neck region, where microsurgery is used to reconnect its blood supply. This technique allows large, complex defects to be reconstructed with well-vascularised, healthy tissue.
The primary goal of head and neck reconstruction is the restoration of function — including swallowing, speech, airway protection, and oral competence. Improving appearance is an equally important secondary goal. Your surgeon will discuss realistic expectations for both functional and cosmetic outcomes at your consultation.
Types of defects managed
Our surgeons reconstruct a wide range of defects resulting from head and neck cancer resection, including those involving composite tissues such as skin, mucosa, muscle, and bone.
Surgical techniques used
The reconstructive approach is tailored to the size, location, and tissue composition of each defect, as well as the patient's overall health and treatment history. The following represent the most commonly used techniques at Coastal Plastic Surgery.
Fibula Free Flap
The most widely used free flap for jaw reconstruction. A segment of the fibula bone — along with overlying skin and muscle — is transplanted to reconstruct the mandible, providing a reliable bone stock for dental rehabilitation.
Anterolateral Thigh (ALT) Free Flap
A versatile fasciocutaneous flap from the outer thigh, used widely for reconstruction of oral cavity, pharyngeal, facial, and neck defects. Can be harvested thin or bulky, and deepithelialised for volume replacement.
Radial Forearm Free Flap
A thin, pliable fasciocutaneous flap from the forearm used for reconstruction of the oral cavity, tongue, floor of mouth, and pharynx. Highly reliable with a long, consistent pedicle.
Rectus Abdominis Free Flap
A muscle or musculocutaneous flap from the abdomen used for large volume defects of the head and neck, providing robust, well-vascularised tissue for complex reconstructions.
Scapular / Parascapular Free Flap
Provides versatile soft tissue with the option of including the scapular bone, useful for complex composite defects of the midface and craniofacial skeleton.
Pedicled Flaps (Pectoralis Major, PMMC)
The pectoralis major myocutaneous flap remains a reliable regional option for head and neck reconstruction, particularly where microsurgical free tissue transfer is not appropriate or available.
Local & Regional Flaps
For smaller or more superficial defects, local tissue rearrangement, cervicofacial advancement flaps, and regional flaps from the neck and chest can provide excellent functional and aesthetic results.
Osseointegrated Implants
Following bony jaw reconstruction, dental implants can be placed into the reconstructed fibula bone to restore dental function — often the final stage of a comprehensive head and neck reconstruction programme.
Free flap reconstruction requires microsurgical expertise to anastomose (connect) the blood vessels of the transplanted tissue to recipient vessels in the neck. This ensures the transplanted tissue remains viable and heals in its new location. Our surgeons have extensive microsurgical training and experience in free tissue transfer for head and neck reconstruction.
A coordinated team approach
Head and neck cancer reconstruction is never performed in isolation. Our plastic surgeons work as part of a comprehensive multidisciplinary team to ensure each patient receives coordinated, evidence-based care from diagnosis through to rehabilitation.
Patients requiring head and neck reconstruction are typically referred by their treating cancer surgeon or oncologist. A GP referral is required for all appointments at our clinic. Please contact our rooms to discuss the referral pathway most appropriate for your situation.
Our specialist plastic surgeons
Head and neck reconstruction at Coastal Plastic Surgery is performed by our FRACS-qualified specialist plastic surgeons, who have expertise in microsurgical free flap reconstruction of complex head and neck defects.
Head & neck reconstruction specialist
Common questions
General information about head and neck reconstruction at Coastal Plastic Surgery. For questions specific to your situation, please contact our practice.
In most cases, reconstruction is performed at the same time as the cancer removal surgery — this is known as immediate reconstruction. The plastic surgeon works alongside the head and neck cancer surgeon in a combined operative procedure. In some situations, delayed reconstruction may be recommended — for example, if the surgical margins are uncertain, if post-operative radiation therapy is planned, or if the patient's medical condition requires a staged approach. Your surgical team will discuss the most appropriate timing for your situation.
Combined cancer resection and free flap reconstruction surgery is major surgery that typically takes between 6 and 14 hours, depending on the complexity of the defect and the type of reconstruction required. Patients generally remain in hospital for 7 to 14 days, during which close monitoring of the flap and recovery of function is managed by the surgical and nursing team.
A free flap is a section of tissue — which may include skin, fat, muscle, and bone — that is surgically removed from a donor site on the body, transplanted to the head and neck region, and re-connected to local blood vessels using microsurgery. Common donor sites include the fibula (for jaw reconstruction), the thigh (ALT flap), and the forearm (radial forearm flap). The donor site is closed with minimal functional impact where possible.
The goal of reconstruction is to restore as much normal function as possible. The degree of functional recovery depends on the extent and location of the original resection, the type of reconstruction performed, and whether radiation therapy is required post-operatively. Speech pathology and swallowing rehabilitation are important components of the recovery programme and are typically commenced during the hospital stay. Your surgical team will provide realistic expectations for your specific situation.
Head and neck reconstruction following cancer surgery is a reconstructive procedure that attracts Medicare item numbers. Applicable rebates will be itemised on your formal quote. Private health insurance may also contribute to theatre and hospital costs. As this surgery is typically performed in conjunction with cancer removal, the treating surgical team will coordinate the Medicare billing process. Please contact our rooms for more information.
Most patients are referred by their treating head and neck cancer surgeon, ENT surgeon, or oncologist. A GP referral is required for all appointments at our clinic. Please contact our Erina rooms on 02 4363 6900 or at info@coastalplasticsurgery.net.au to discuss the referral pathway appropriate for your situation. In urgent cases, please ask your referring doctor to contact us directly.
Require head & neck reconstruction?
Contact Coastal Plastic Surgery to discuss a referral to our specialist plastic surgeons. We work as part of a coordinated multidisciplinary team to restore form and function following head and neck cancer treatment.