Cancer Reconstruction Surgery in Pune: Restoring Form and Function

What is cancer reconstruction surgery?

Removing a cancer often means taking away a margin of healthy tissue around it. The gap left behind can affect appearance and function: a missing part of the nose or lip, a defect in the mouth that affects eating and speech, exposed tendons on a limb, or the loss of a breast. Reconstruction rebuilds these areas.

Reconstructive surgeons use a step-by-step approach, sometimes called the reconstructive ladder, choosing the simplest method that will give a reliable, functional result:

• Direct closure with stitches for small defects.
• Skin grafts, which cover shallow wounds with skin from elsewhere; see skin grafting surgery.
• Local flaps, which move nearby skin with its own blood supply to match colour and texture.
• Regional flaps, which bring larger amounts of tissue from nearby areas, such as the chest or forehead.
• Free flaps, which transfer tissue from another part of the body and reconnect its blood vessels with microsurgery.

Who may benefit, and how is it planned?

Reconstruction is considered for anyone whose cancer surgery will leave a defect that affects function or appearance. Planning involves:

1. The cancer plan: the type and extent of surgery, and whether radiotherapy or chemotherapy will follow.
2. The defect: its size, depth and which structures, such as bone, nerves or lining, need replacing.
3. Your health: smoking, diabetes, heart and lung conditions, and nutrition.
4. Donor sites: where tissue can be taken with the least effect.
5. Your priorities for appearance and function.

What are the options by area?

Area	Common reconstruction	Points to consider
Skin cancers of the face	Direct closure, local flaps or full-thickness grafts	Scars placed along natural lines
Mouth and tongue	Local, regional or free flaps	Aims to restore eating and speech
Jaw bone	Bone-containing free flaps or plates	Complex, often long operation
Limbs and trunk	Grafts, local flaps or free flaps	Protects tendons, bone and joints
Breast	Implants, flaps or both	See breast reconstruction

Free flaps depend on joining small blood vessels, as described under vessel repair surgery.

How is reconstruction performed?

1. Cancer removal by the cancer surgeon, with margins checked.
2. Defect assessment: the reconstructive surgeon measures what is missing.
3. Harvest: the graft or flap is raised from the donor site.
4. Inset: the tissue is shaped and stitched into the defect; for free flaps, the artery and vein are joined under a microscope.
5. Donor-site closure and dressings.
6. Monitoring: flaps are checked closely in the first days.

How should you prepare, and what should you ask?

• Stop smoking; it greatly increases flap and wound problems.
• Improve nutrition before major surgery, with a dietitian if needed.
• Bring all scans, biopsy reports and the cancer treatment plan.

Questions to ask:

• What will be removed, and how will it be rebuilt?
• Where will tissue be taken from, and what will that area look like?
• How will radiotherapy affect the reconstruction?
• What therapy will I need afterwards for speech, swallowing or movement?

What is recovery like?

Time	What to expect for most patients
Days 1-5	Flap monitoring; pain control; drains; early movement
Weeks 1-2	Home for most; stitches removed; wound checks
Weeks 2-6	Swelling settles; therapy for speech, swallowing or movement as needed
Months	Radiotherapy if planned; refinements such as flap thinning later

What are the risks?

• Flap failure, partial or complete, which may need further surgery.
• Wound infection or breakdown, more likely after radiotherapy.
• Donor-site problems: scars, weakness or numbness.
• Functional changes, such as altered speech, swallowing or movement.
• Need for further operations to refine the result.
• General risks of long operations, including blood clots and chest infections.

Contact the team urgently if a flap changes colour, becomes cold or swollen, or if you develop fever, breathing difficulty or bleeding.

What results can you expect?

Reconstruction can restore much of the appearance and function lost to cancer surgery, although the result is rarely identical to before. Many people return to eating, speaking, working and their usual activities, with therapy and time.

Is reconstruction necessary, and what are the alternatives?

Removing the cancer always comes first, and reconstruction is planned around it. Small defects, especially on the skin, may heal by themselves with dressings or be closed directly with stitches. Larger gaps are a different matter. In the mouth, an unrepaired defect can make chewing, swallowing and speech difficult. Near the eye, a gap left to scar can pull the lower eyelid down. In the neck or on a limb, bare bone, tendon or major vessels need healthy cover to avoid infection, and a wound that will not heal can hold up radiotherapy.

Breast reconstruction is different: it is always a personal choice. Some women prefer an external breast form (prosthesis) worn in the bra, or no reconstruction at all, and delayed reconstruction remains possible later.

Common myths about cancer reconstruction

• “Reconstruction is only cosmetic, not part of cancer treatment.” It restores eating, speech, movement and cover for vital structures.
• “Rebuilding the area will hide the cancer if it comes back.” Follow-up examinations and scans continue after reconstruction and are planned with this in mind.
• “Reconstruction will delay my cancer operation.” It is usually done at the same operation as removal and is planned so that further treatment is not held up.
• “After radiotherapy, nothing more can be done.” Radiotherapy makes tissue harder to heal, but tissue moved with its own blood supply, such as a flap, often copes well.

What affects the cost of cancer reconstruction surgery in Pune?

• Size and site of the defect.
• Method: graft, local flap, regional flap or free flap.
• Operating time, hospital stay and intensive monitoring.
• Therapy and follow-up after surgery.

Reconstruction after cancer surgery is usually part of cancer treatment and is often covered by health insurance, subject to your policy.