How to resolve facial sagging post cancer treatment?

Hi, it's great that you've been cancer free for the last 4 years. You very nicely outlined the problems your plastic surgeon would be challenged to solve: paralysis of the nerve, loss of volume and facial movement from the muscle removal, and the skin's poor healing capacity after radiation.  You do have options, but it depends on how aggressive you and your surgeon are willing to be. Options range from very straight-forward (I would never call any surgery "simple") procedures that can basically tighten the skin to provide some degree of symmetry... all the way to very complex operations which transfer nerves, muscles, and even brand new skin to your face. You may need several operations but this would be discussed. And you would have to expect the entire reconstructive process to take several months. This may sound obvious, but it should be stated that you will never have the same appearance or symmetry as you did before your cancer treatment. However, plastic surgery has come a long way, with free flaps and fat transfer techniques and such, that many in your situation can expect pretty decent results. I would suggest a teaching hospital, but there may be plastic surgeons in private practice that would take your case. I wish you all the best.

Any surgery after radiation is fraught with hazard. This does not eliminate you as a candidate but any surgeon should proceed with caution. More information is needed to discuss your particular case.

Typically most surgeons avoid facelift procedures on patients who have had radiation therapy due to the reduced blood flow and healing process. There are newer approaches that allow us to improve the symmetry of the face with more conservative facial surgery techniques. Each patient needs to be individually assessed since the skin consistency differs from one patient to another. Good luck!

It sounds like you may have suffered from facial paralysis from injury to the facial nerve branches.  Surgeries to improve the sequelae from facial nerve injuries have been well described and should be considered in your case.  Strategies include surgeries to reanimate the face or static procedures to improve symmetry.  Radiation changes to the skin can limit your options but a safe set of procedures should be able to improve your situation.  Best wishes!

I would not rule out surgery to improve symmetry or facial shape. You would need to be evaluated by a Facial Plastic Surgeon. The important questions are what type of radiation/ surgery you have undergone as well as whether surgery can achieve your goals. In many cases this is possible. I've recommended a Facial Plastic Surgeon because they have performed the head and neck cancer and reconstructive surgeries that you've undergone and understand how those procedures can change your underlying anatomy. Facial Plastic Surgeons typically also have experience with operating on many patients who have undergone head and neck irradiation. It is possible that you might also have Plastic Surgeons in your area that have this skillset. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

At 4 years out there are certainly options regarding your facial palsy. There are static solutions and dynamic solutions and you need to see someone with a specialist interest in facial palsy. It would be likely that the surgeon who performed your original surgery may well be the best person to recommend or refer you on. Often facial palsy centres are linked to centres that perform head and neck cancer oncology and reconstruction

Radiation therapy certainly effects skin quality and wound healing.  Despite this, there are still many options to improve your condition.  However, it is difficult to accurately say without knowing the details of your cancer treatment and the current severity of your condition.  Nevertheless, possibilities include eyelid tightening procedures and static or dynamic suspension techniques to improve the drooping of the mouth.  Skin tightening or removal procedures should be performed with caution.  As always, it is important to personally consult with a board-certified Plastic Surgeon.