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CION Cancer Clinics
Facial appearance and cheek support after a maxillectomy | CION Cancer Clinics
Your face will be swollen and look different in the first weeks after a maxillectomy, and then it will settle. How different it looks in the long run depends on how much of the upper jaw was removed and what was put back to hold the cheek out. This page explains what changes, what settles on its own, what needs a plan, and what can be improved later. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- How will my face look after a maxillectomy?
- What the face looks like week by week, then month by month
- What holds the cheek out once the bone has gone
- What settles on its own, and what needs a plan
- Four things families say about the face, and what is true
- Living with the change, and what this page cannot tell you
- Common questions about appearance after maxillectomy
The short answer
How will my face look after a maxillectomy?
Your face will look swollen and different in the first weeks, and then it will settle. How different it looks in the long run depends on how much of the upper jaw was removed and what was put back to support the cheek. Many people end up with a face others do not notice. Some have a visible change that a plate, a flap or a later operation can improve.
Why the cheek changes
The maxilla is the upper jaw. It is the bone that holds the cheek out, supports the lower eyelid and gives the upper lip its shape. When part of it is removed for cancer, the soft tissue of the cheek loses the shelf it was resting on. Without support it can sink inwards and the lip and eyelid on that side may sit lower. The more bone removed, the more support has to be put back.
Where the cut is made
Some maxillectomies are done entirely through the mouth, leaving no scar on the face. Larger ones use a cut that runs beside the nose and under the eye, or along the upper lip, so that the cheek can be lifted aside. These scars are placed in natural creases and fade over months, but they do not vanish.
Ask your surgeon before the operation whether the cut will be inside the mouth or on the face. It is a fair question and the answer is usually known in advance.Over time
What the face looks like week by week, then month by month
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The first week
Heavy swelling of the cheek and eyelids, often with bruising that spreads down the face. The eye on that side may be swollen almost shut. This is the point at which the face looks its worst, and it is not what you will look like.
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Weeks two to six
Swelling comes down steadily. The scar, if there is one on the face, is red and raised. Numbness of the cheek and upper lip is common because small nerves were cut, and it can make the face feel stiff or lopsided even when it does not look so.
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The first few months
The real shape emerges. If the cheek is sinking in, this is when it shows. The plate is refined and, if you have a flap, its bulk settles. Numbness slowly recedes and feeling returns patchily.
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After radiotherapy, if given
Radiotherapy can tighten and darken the skin over the treated area for a while, and can stiffen a flap. This usually eases in the months after the course ends.
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A year on
Scars have faded to pale lines. The shape is settled. This is the point at which any further operation to improve the contour is usually considered, once the team is confident about the cancer.
Not sure whether this applies to you?
Ask an oncologistPutting support back
What holds the cheek out once the bone has gone
One or more of these is used. Which ones depends on the size of the gap and on your own wishes and fitness.
The obturator plate
A well-made plate does more than seal the palate. Its upper part fills the cavity and pushes the cheek out from inside. A plate that has shrunk with the cavity can let the cheek fall, which is one reason refits matter for appearance as well as eating.
A soft tissue flap
Tissue moved from the thigh, arm or back fills the space and holds the cheek from within. It can look too full at first and then settle. Bulk can be trimmed later.
Often chosen when
- The gap is large or the cheek skin was removed
- The eye socket floor needs support
A bone flap
Bone from the lower leg or shoulder blade, with its own blood supply, rebuilds the missing shelf. It gives the most natural contour and can carry dental implants, at the cost of a longer operation and a second wound.
Later touch-ups
Once everything has settled, smaller procedures can lift a drooping lower eyelid, thin a bulky flap, add fat to a hollow, or revise a scar. These are planned a year or more after the main operation.
Ask what can be done later, not only what is being done now.What to expect
What settles on its own, and what needs a plan
Usually settles with time
Usually needs something done
Settles: swelling and bruising of the cheek and eyelids
Needs a plan: a cheek that is clearly sunken once swelling has gone
Settles: a red, raised scar that fades to a pale line
Needs a plan: a scar that pulls the lip or eyelid out of position
Settles: numbness of the cheek and upper lip, slowly
Needs a plan: a lower eyelid that droops and leaves the eye watering
Settles: a flap that looks too full in the first months
Needs a plan: a flap still bulky a year on, or a plate that no longer supports the cheek
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Commonly believed
Four things families say about the face, and what is true
"The face will be disfigured for life."
The face in the first week is not the face at one year. Swelling goes, scars fade, and the plate or flap holds the cheek. Some people have a visible change; many do not have one that strangers notice. What cannot be predicted from the early days is which group you will be in.
"A smaller operation would have kept her looks."
The amount removed is set by where the cancer is, not by choice. Leaving cancer behind to keep the contour is not a trade any surgeon will offer. What can be chosen is how the support is put back, and that conversation is worth having before surgery.
"Plastic surgery afterwards is only for the rich."
Reconstruction that is part of the cancer treatment plan is usually claimable under Aarogyasri, CGHS, ECHS, EHS and most cashless insurance. Later cosmetic refinements vary by scheme. Ask for a written breakdown rather than assuming.
"He should stay indoors until it looks normal."
Staying hidden makes the change loom larger, for him and for everyone around him. Most people find that going out early, with a scarf or a cap if they wish, is easier than going out late. A counsellor can help if the first outing feels impossible.
Being straight with you
Living with the change, and what this page cannot tell you
The people who cope well are usually not the ones with the smallest change. They are the ones who were told beforehand what to expect and who went back to ordinary life sooner rather than later. If you are the son or daughter reading this, your calm reaction to the face in the first week matters more than you think.
Scar and skin care
Keep a facial scar out of strong sun for the first year, with a cap or sunscreen once the wound has closed. Gentle massage with a plain moisturiser, once your surgeon says it is safe, helps it soften. Do not apply turmeric, oils or ointments to a fresh wound without asking.
What this page cannot tell you
It cannot tell you how your own face will look. That depends on how much bone is removed, whether the cheek skin or the eye is involved, what is used to support the cheek, and whether radiotherapy follows. Ask your surgeon to show you, on your scan, what will be removed and what will hold the cheek. Ask what can be improved later.
If the change in your face is affecting how you live, say so at a review. It is treated as a real problem, not vanity.Questions we are asked
Common questions about appearance after maxillectomy
Will there be a scar on my face?
Not always. Smaller maxillectomies are often done entirely through the mouth. Larger ones need a cut beside the nose and under the eye, or through the upper lip, placed in natural creases. Ask your surgeon which is planned for you. The answer is usually known before the operation.
How long will the swelling last?
The heavy swelling of the first week eases over the following weeks. Some fullness of the cheek can persist for months, particularly after a flap, and is often the last thing to settle. Sleeping propped up helps in the early weeks.
Why is my cheek numb?
The nerve that gives feeling to the cheek, upper lip and upper teeth runs through the maxilla, and is usually cut or bruised. Feeling returns slowly and patchily over months, and in some people part of the cheek stays numb. Be careful with hot drinks and shaving on that side.
Can the sunken cheek be corrected later?
Often, yes. A plate can be rebuilt with more bulk, fat can be added to a hollow, or a small flap can be brought in. These are usually planned a year or more after surgery, once the team is confident about the cancer and the tissue has settled. Ask what would be possible in your case.
Will the eye on that side look different?
It may sit slightly lower, or the lower lid may droop a little, if the floor of the eye socket was involved. Both can be improved with small procedures once things have settled. If you have double vision or the eye is bulging, that is a separate matter and needs review promptly.
Can I grow a beard or use make-up over the scar?
Yes, once the wound has fully closed and your surgeon agrees. Many men grow a beard to cover a lip or cheek scar. Ordinary make-up is fine on healed skin. Keep both off any area that is still being treated with radiotherapy until the team says otherwise.
How do I explain the change to children or neighbours?
Briefly and plainly. Children accept a short honest answer far more easily than adults expect. Having one sentence ready, such as an operation for a growth in the jaw, takes the awkwardness out of the first few meetings. A counsellor can help you find your own words.
Is later cosmetic surgery covered by insurance?
Reconstruction done as part of the cancer treatment is usually claimable. Later refinements are sometimes treated as cosmetic and sometimes as part of rehabilitation, and schemes differ. Ask for a written opinion from the hospital insurance desk before planning, and call the helpline if you need help.
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Sources
- Macmillan Cancer Support — Head and neck cancer
- Cancer Research UK — Surgery for mouth cancer
- American Cancer Society — Surgery for Nasal Cavity and Paranasal Sinus Cancer
- NHS — Mouth cancer: treatment
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
Eye Position and Vision After MaxillectomyWhen the eye socket floor is part of what was removedFlap Reconstruction vs ObturatorThe two ways of putting support backWound, Stitches and ScarsLooking after a facial wound as it healsLife After Maxillectomy: An Honest AccountAppearance, eating and speech in the long runThe Emotional Side of Cancer SurgeryCoping with a change in how you look
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Worried about how you will look after jaw surgery?
Send us your scan or call the helpline. A surgical oncologist can tell you where the cut would be, what would hold the cheek, and what could be improved later. One helpline serves every CION centre.