Medical Oncologist
CION Cancer Clinics
Facial appearance after mandibulectomy | CION Cancer Clinics
If the jawbone is rebuilt with bone at the same operation, most people keep the shape of their face, with a scar under the jawline and some change on the operated side. The early weeks look far worse than the final result because of swelling. This page explains what changes, why, how it settles over the first year, and what can be adjusted later. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- How will the face look after part of the jaw is removed?
- How the face changes over the first year
- What actually changes, and why
- With bone reconstruction and without, compared
- The words on the plan, in plain language
- What families fear, and what usually happens
- What this page cannot tell you
- Common questions about the face after jaw surgery
The short answer
How will the face look after part of the jaw is removed?
If the jawbone is rebuilt with bone at the same operation, most people keep the shape of their face, with a scar on the neck and some fullness or flatness on the operated side. If only the edge of the bone is removed, the outside of the face usually changes very little. The biggest change comes when a full segment is removed and not rebuilt.
Why the early weeks are misleading
For the first few weeks the face is swollen, the chin may look pulled to one side, and the skin over the flap can look bulky or shiny. None of that is the final result. The shape you will live with appears over months, not days.
Which part was removed matters more than how much
The front of the jaw carries the chin and holds the lower lip forward. Losing bone there without replacement lets the chin fall back and the lip droop. The side of the jaw gives the face its width; losing bone there flattens one side. Ask your surgeon which part is being removed before the operation.
Nobody can promise you a particular appearance. What can be described honestly is the range people with your operation usually end up in.Month by month
How the face changes over the first year
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The first week
Swelling is at its worst. There may be a breathing tube in the neck, a feeding tube through the nose, and drains. The flap looks pale and puffy. This is the stage families find hardest to look at, and it passes.
-
Weeks two to six
Swelling comes down steadily. The scar on the neck is red and firm. Numbness of the lip and chin is usual. The outline of the jaw starts to show through, and you get a first honest idea of the shape.
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Months two to six
The scar softens and fades from red towards skin colour. The flap shrinks a little as swelling leaves it. If radiotherapy is given in this period, the skin can darken and tighten for a time.
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Six months to a year
This is close to the settled result. Teeth or a denture can now be planned if they were not fitted earlier, and a missing row of teeth is often the last thing that makes a face look different.
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After a year
If something still bothers you, this is when small revision operations are usually discussed, because the tissues have stopped changing and the result of any adjustment can be judged.
Not sure whether this applies to you?
Ask an oncologistPiece by piece
What actually changes, and why
The scar
Most jaw operations are done through a cut in a skin crease of the upper neck, so the scar sits under the jawline. If the tumour is at the front, the surgeon sometimes splits the lower lip to reach it, and that scar is the one people notice.
The jawline
With bone reconstruction, the outline is usually kept but may be slightly lower or flatter on one side. Without reconstruction, the chin and jaw drift towards the operated side over time.
Depends on
- Edge removed, or a full segment
- Front of the jaw, or the side
- Bone flap, plate alone, or nothing
The lip and chin
The nerve that gives feeling to the lower lip runs inside the jawbone, so numbness on that side is expected. A numb lip can look as if it droops, and can let saliva or food escape at the corner without you knowing.
The neck
When lymph glands are removed from the neck at the same time, that side of the neck looks slimmer or slightly hollow. The shoulder on that side may sit a little lower for a while.
Side by side
With bone reconstruction and without, compared
Jaw rebuilt with bone
Segment removed, not rebuilt
Rebuilt: the outline of the jaw is largely kept
Not rebuilt: the chin drifts towards the operated side
Rebuilt: the lip is held forward by the new bone
Not rebuilt: the lower lip falls back and can droop
Rebuilt: teeth or implants can usually be planned later
Not rebuilt: a denture is hard to fit on that side
Rebuilt: a longer operation, with a second wound on the leg or hip
Not rebuilt: a shorter operation, sometimes chosen for health reasons
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On your operation notes
The words on the plan, in plain language
- Marginal mandibulectomy
- Only the top edge of the jawbone is removed. The lower border stays, so the outside of the face usually keeps its shape.
- Segmental mandibulectomy
- A full-thickness piece of the jaw is cut out, leaving a gap. This is the operation that changes the face unless the gap is rebuilt.
- Free flap
- Bone or skin taken from elsewhere in the body with its own blood vessels, joined to vessels in the neck. The fibula from the lower leg is the usual bone.
- Lip-split approach
- The lower lip is cut through the middle to reach the tumour. The scar is placed in the natural groove and usually fades well.
- Neck dissection
- Removal of lymph glands from the neck. It changes the neck contour, not the jaw.
- Revision
- A later, smaller operation to thin a bulky flap, adjust a scar or improve the chin outline once healing has finished.
Commonly believed
What families fear, and what usually happens
"Everyone will be able to tell from across the room."
After a rebuilt jaw, most people pass unnoticed in public once the swelling has gone. Close family will see the difference. Strangers usually notice a neck scar, if anything.
"A scar through the lip means the face is ruined."
The lip-split scar is placed along the natural groove of the chin and lip. It is obvious for some months and then fades to a fine line in most people. Surgeons use it only when the tumour cannot be reached another way.
"He should not look in a mirror until it has healed."
Seeing the face early, with a nurse or counsellor beside you, is usually less frightening than imagining it. Being kept from a mirror tells the person the family thinks it is worse than it is.
"Once it has healed, nothing more can be done."
Flap thinning, scar revision, fat grafting and dental rehabilitation are all possible later. They are usually discussed after a year, once the tissues have settled and any radiotherapy is well behind you.
Being straight with you
What this page cannot tell you
It cannot tell you how your own face will look. That depends on which part of the jaw is removed, whether it is rebuilt, whether the lip is split, whether the neck is operated on, and whether radiotherapy follows. Ask your surgeon to draw the plan on a diagram of the face.
Who this affects most
People whose tumour sits at the front of the jaw, people who are not fit enough for a long reconstruction, and people who will need radiotherapy afterwards. If that is you, ask early what support is available for the change, not after it has happened.
The part nobody prepares you for
Most people are not upset by the scar. What upsets them is the first time a grandchild hesitates, or a photograph from a family function. That is normal, and worth saying out loud to your team. CION has counsellors who see people before and after head and neck surgery.
If you notice a new lump, a sore that will not heal, or a change in the shape of the face months after healing, have it checked. That is not about appearance.Questions we are asked
Common questions about the face after jaw surgery
Will there be a scar on the face?
Usually the main scar is on the upper neck, under the jawline, where a collar or a dupatta covers it. A scar on the face itself happens only when the lip has to be split to reach a tumour at the front. Ask which approach is planned for you.
Will the chin look pushed to one side?
It can, especially in the first weeks when swelling pulls everything out of line. If the bone has been rebuilt, the chin usually settles back close to the middle. If a segment was removed and not rebuilt, some drift towards that side is expected.
Why does the lip droop on that side?
Partly numbness, because the nerve to the lip runs through the jawbone and is often cut with it. Partly swelling. Partly, if the front of the jaw is missing, because nothing holds the lip forward. The shape improves as swelling goes.
Can the flap on the face be made thinner?
Often, yes. The skin taken with a bone flap is thicker than the lining it replaces and can look bulky. Surgeons wait until healing is complete and any radiotherapy is finished, then thin it in a small operation. Ask at a review visit, not in the first weeks.
Will I be able to smile normally?
The muscles that lift the corners of the mouth are usually not touched, so the smile itself works. A numb or slack lower lip on one side can make the smile look uneven, and missing teeth show when you smile. Both improve with time and with dental rehabilitation.
Does radiotherapy after the operation change the face?
During and shortly after a course the skin can redden, darken and tighten, and the neck can feel stiff. Most of that settles. Some tightness and a little skin thickening can stay. Your radiation oncologist will explain what to expect.
When can I go back to work and family functions?
Many people return to work within a few months, depending on the job and whether radiotherapy follows. Family functions are a matter of confidence more than healing. A small one early, with someone you trust, is often easier than waiting for a big one.
Is there help for how I feel about my face?
Yes. Counselling before and after head and neck surgery is part of care at CION, and asking is not a weakness. Speech and swallowing therapists also help with lip control and saliva. Call the helpline and ask for the counselling team.
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Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
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Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
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Hematologist
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Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- Cancer Research UK — Surgery for mouth cancer
- Macmillan Cancer Support — Head and neck cancers
- NHS — Mouth cancer: treatment
- American Cancer Society — Surgery for oral cavity and oropharyngeal cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Marginal vs Segmental MandibulectomyThe single biggest factor in how the face changesFibula Free Flap Jaw ReconstructionHow the jaw is rebuilt with bone from the legNumbness of the Lip and Chin After Jaw SurgeryWhy the lip feels and looks different afterwardsThe Emotional Side of Cancer SurgerySupport for the part of recovery that is not physicalWound, Stitches and ScarsHow scars heal and how to care for them
Talk to us
Worried about how the face will look?
Tell us what operation has been proposed. A surgical oncologist will explain which part of the jaw is involved and what that usually means for appearance. One helpline serves every CION centre.