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Maxillectomy: what the operation involves | CION Cancer Clinics
A maxillectomy removes part or all of the upper jaw bone, together with the cancer growing in it. You are fully asleep, and the hole left in the roof of the mouth is closed on the same day with a removable plate, a flap of tissue, or both. This page explains how the surgeon reaches the bone, what the hospital stay involves, and what your team weighs before offering it. 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
- What happens in a maxillectomy?
- How does the surgeon reach the upper jaw?
- What happens during the hospital stay?
- What do the words on the consent form mean?
- What do families often get wrong about this operation?
- What does your team weigh, and what can this page not tell you?
- Common questions about maxillectomy
The short answer
What happens in a maxillectomy?
A maxillectomy removes part or all of the maxilla, the bone of the upper jaw, along with the cancer growing in it. You are fully asleep, and the hole left behind is closed on the same day with a plate, a flap of tissue, or both.
What the maxilla actually is
The maxilla is more than the bone that holds your upper teeth. It forms the roof of your mouth, the floor and side walls of the nose, the hollow space in the cheek called the maxillary sinus, and the floor of the eye socket. This is why one operation can affect eating, speech, the nose and sometimes the eye.
Why it is done
It is most often done for cancers that start in the roof of the mouth, the upper gum, the maxillary sinus or the inside of the nose. The aim is to take the cancer out with a rim of healthy tissue around it. How much bone goes depends on where the cancer sits and how far it has spread, which is decided from scans and a biopsy before the day.
This page describes what usually happens. Your own operation may differ, and your surgeon will explain the plan made for you.Getting to the cancer
How does the surgeon reach the upper jaw?
There are several routes in. The one chosen depends on the size and position of the cancer, not on which leaves the smallest scar.
Through the open mouth
For small cancers low in the palate or gum, the surgeon can often work entirely inside the mouth. There is no cut on the face at all.
Under the upper lip
A cut inside the mouth, where the lip meets the gum, lets the soft tissue of the face be lifted up like a sleeve. The bone is reached without a visible scar.
Along the side of the nose
For larger cancers, a cut runs from beside the nose down through the upper lip, and sometimes under the lower eyelid. It follows natural creases, so the scar usually fades well.
Often needed when
- The cancer is large or high in the sinus
- The eye socket floor is involved
Through the nose with a camera
Some cancers inside the nose and sinus can be removed with thin instruments and a camera passed through the nostrils. Ask your centre whether this suits your cancer.
Not sure whether this applies to you?
Ask an oncologistFrom admission to home
What happens during the hospital stay?
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The days before
You have blood tests, a heart and lung check and a meeting with the anaesthetist. Many teams also send you to a prosthodontist, a dentist who makes plates, to take moulds of your mouth before surgery.
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The operation
You are under general anaesthesia throughout. The surgeon removes the planned bone and tissue. Lymph nodes in the neck may be removed in the same sitting if the plan calls for it.
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Closing the hole
The space is either packed and covered with a temporary plate, or filled with a flap of tissue. A tracheostomy, a small breathing tube in the front of the neck, is sometimes placed for the first few days.
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The first days after
You are fed through a thin tube in the nose at first. Your face will be swollen and your cheek may feel numb. Nurses check the wound, the packing and your breathing closely.
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Packing out and going home
The packing and temporary plate are usually taken out about a week later. A new plate is fitted, you learn to clean the area, and most people go home soon after.
!
After you go home, this cannot wait
Fresh bleeding from the mouth or nose that does not settle with gentle pressure, a sudden increase in swelling of the face, new trouble breathing, or clear watery fluid dripping steadily from the nose all need same-day care. Go to the nearest emergency department and say you have had a maxillectomy. Do not wait for your next clinic visit.
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On your paperwork
What do the words on the consent form mean?
- Partial or total maxillectomy
- Whether part of the upper jaw bone is removed, or all of it on one side.
- Obturator
- A removable plate, a little like a denture, that seals the hole between the mouth and the nose.
- Free flap
- Skin, muscle or bone moved from another part of the body, with its blood vessels joined under a microscope, to fill the space.
- Margin
- The rim of healthy tissue around the cancer. A clear margin means no cancer cells were seen at the edge of what was removed.
- Neck dissection
- Removal of lymph nodes, the small glands in the neck, to check whether the cancer has spread to them.
Commonly believed
What do families often get wrong about this operation?
"The face will be left with a hole in it."
The hole is inside the mouth, in the palate, not on the face. It is sealed with a plate or a flap. Many people who have had a maxillectomy look much the same in ordinary clothes and company, though some change to the cheek is common.
"He will never eat or speak normally again."
With a well-fitted plate or a flap, most people return to eating by mouth and speak clearly enough to be understood. It takes practice, and a speech and swallowing therapist helps with both.
"Surgery in the face spreads the cancer."
Surgery does not make a cancer spread. Delaying a planned operation gives the cancer time to grow into the eye socket or skull base, which makes the operation larger.
"If the teeth are loose, the dentist can pull them first."
Loose upper teeth can be a sign of a cancer in the jaw. Pulling them before a biopsy can delay the diagnosis. Tell the dentist about any sore, lump or numbness in the area.
Being straight with you
What does your team weigh, and what can this page not tell you?
Whether a maxillectomy is right for you is a decision for your treating team and you together. This page cannot make it, and it cannot tell you how your own recovery will go.
What the team looks at
They look at where the cancer is, whether it has reached the eye socket, skull base or skin, your general health, your teeth, and whether radiotherapy will follow. They also consider whether the cancer can be removed with clear margins at all. For some cancers, radiotherapy with or without chemotherapy is offered instead.
Who it may not suit
An operation of this size may not be offered when the cancer has spread widely, when it has grown deep into the skull base, or when heart or lung health makes a long anaesthetic unsafe.
Questions worth asking
Ask how much bone will be removed, how the hole will be closed, whether the eye is at risk, who will make the plate, and what the plan is if the margins are not clear.
Questions we are asked
Common questions about maxillectomy
How long does a maxillectomy take?
It depends on how much is removed and how the hole is closed. A small partial operation closed with a plate takes a few hours. A larger operation with a free flap or neck dissection can take most of a day. Your surgeon can give you a better idea once the plan is final.
Will there be a scar on my face?
Not always. Many operations are done through the mouth or under the upper lip, with no scar on the face. Larger cancers may need a cut beside the nose and through the lip. That scar follows natural lines and usually fades, but it does not disappear entirely.
Will I lose my upper teeth?
The teeth sitting in the bone that is removed go with it. Teeth on the other side are kept where possible, because they help hold the plate in place. Ask your surgeon which teeth will be lost before the operation, so the prosthodontist can plan around them.
How much pain should I expect?
Most people describe soreness and pressure more than sharp pain, and the cheek is often numb, which dulls it further. You are given regular pain relief in hospital and for home. Tell the nurses if it is not controlled, because it can nearly always be improved.
When can I eat normally?
You start with tube feeds, then move to liquids and soft food once the team is happy with the wound. Chewing on the operated side takes longer. Most people eat soft food by mouth before they go home, and build up from there over the following weeks.
Will I need radiotherapy afterwards?
Many people do, depending on what the pathology report shows about the margins, the size of the cancer and the lymph nodes. The team decides after the report is ready. Radiotherapy can make the tissue tighter, so your plate may need adjusting during and after it.
Who else will be involved besides the surgeon?
Usually an anaesthetist, a prosthodontist who makes the plate, a speech and swallowing therapist, a dietitian and specialist nurses. If a flap is used, a reconstructive surgeon may join. Radiation and medical oncologists come in if further treatment is planned.
Is maxillectomy covered by Aarogyasri or insurance?
Cancer surgery is often covered when it is part of an approved treatment plan. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled. Cover for the plate and later dental work can differ, so call the helpline with your card details before admission.
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Sources
- Cancer Research UK — Surgery for nasal and sinus cancer
- National Cancer Institute — Paranasal Sinus and Nasal Cavity Cancer Treatment (PDQ) - Patient Version
- American Cancer Society — Nasal Cavity and Paranasal Sinus Cancer
- Macmillan Cancer Support — Head and neck cancer
- NICE — Cancer of the upper aerodigestive tract: assessment and management in people aged 16 and over (NG36)
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
Partial, Total and Extended MaxillectomyHow much bone is removed, and why it variesThe Hole Left in the Palate and What Closes ItPlates and flaps, explained side by sideWhen the Eye Has to Be Removed With the MaxillaWhen the eye socket is part of the operationThe Days Before Your OperationTests, fasting and what to bring
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