When oral cancer or massive tumors destroy the jaw, Dr. Manish Tiwari utilizes the Free Fibula Osteocutaneous Flap—transplanting bone and blood vessels from your leg to seamlessly recreate your facial skeleton and prepare you for dental implants.
Rebuilding the lower jaw after massive bone removal due to aggressive oral cancers.
Reconstructing the upper jaw and palate to prevent facial collapse and restore normal speech.
Restoring the jaw structure after the enucleation of large, destructive benign jaw tumors.
Replacing dead, irradiated jaw bone with healthy, vascularized living bone.
The fibula is a non-weight-bearing bone in the lower leg. Removing a section of it does not affect your ability to walk or run, but it provides the absolute best material for rebuilding the human jaw.
The fibula offers up to 25 cm of straight, dense bone. This allows Dr. Tiwari to make multiple precise cuts (osteotomies) to perfectly mimic the natural curve of your chin and jawline.
Unlike other bone flaps (like the scapula or rib), the fibula has thick cortical bone. This makes it strong enough to safely anchor titanium dental implants, allowing you to chew solid food again.
The FFOCF is an "Osteocutaneous" flap. This means Dr. Tiwari can harvest the bone *along with* an attached pad of skin and muscle to simultaneously rebuild the inside lining of your mouth or tongue.
We leave nothing to chance. Dr. Tiwari utilizes advanced 3D computer modeling to plan the exact jaw cuts and reconstruction weeks before you enter the operating room.
Using your CT scans, we 3D-print custom cutting guides. This ensures the diseased jaw is removed perfectly and the new leg bone is cut to match the exact angles of your original face.
While Dr. Tiwari removes the tumor from the head and neck, a second surgical team carefully harvests the fibula bone and its delicate blood vessels from the leg.
The bone is secured into the face with custom titanium plates. Using a high-powered microscope, the leg's blood vessels are sewn into the neck's arteries to bring the new bone to life.
Before we can use your leg bone, we must ensure it is safe to do so.
Recovery involves healing both the face and the leg simultaneously.
