Can I Get An Implant To Reconstruct My Face After Radiation Treatments?

Q: Dr. Eppley, My facial reconstruction situation may be very complicated, I am just exploring all options to see if this is even viable for me. Just to give some background to my situation, to begin I was diagnosed with a maxillary sinus sarcoma on the right side. I had surgery to remove it, right infrastructure maxillectomy.  I then had 30 treatments of radiation therapy, then 18 weeks of chemotherapy.  All is clear now and my Dr is discussing reconstruction.  The reconstructive surgery poses a lot of risks because of the irradiated tissue. If there were a way to do an implant rather than the microvascular tissue transplant surgery I would be interested to know how or if it could be done. 

A: Thank you for your inquiry and detailing your facial reconstruction issues. The key concept to fully grasp is that radiation really adversely affects the tissues when it comes to healing. Getting healthy new vascularized tissue into the defect site is the key to changing the vascular environment now damaged by the radiation. While a microvascular tissue transfer is far from appealing, this is the only type of baseline reconstruction you should have. You have to change the tissues both in volume and vascular quality first. An implant in this situation would be completely contraindicated. The risk of microvascular tissue transfer today are far lower and it is a much more reliable procedure than it was twenty years. Even then when I did such surgery the success rates in the face were every high. (survival of the transplanted tissue)

Dr. Barry Eppley

Indianapolis, Indiana