(BPT) - Looks matter. And for cancer survivors who've undergone major facial surgeries, changes to their appearance and function can be emotionally and physically devastating. For many, reclaiming a sense of normalcy after facial reconstruction is an uphill battle.
Now, a multidisciplinary team at the Hollings Cancer Center at the Medical University of South Carolina (MUSC), the state's only National Cancer Institute-designated cancer center, is offering new hope through an advanced procedure called Jaw in a Day. This groundbreaking surgery restores both function and appearance in a single operation, allowing patients to leave the hospital able to eat, speak and smile with confidence.
Previously offered at MUSC only for benign cases, the procedure is now available for patients with head and neck cancer, many of whom require jawbone removal as part of treatment or as a result of radiation-related side effects.
"That we can fix a devastating side effect of cancer treatment and give them back the shape of their face and their teeth — and do it in a way that's timely so they leave the OR that day with a set of smiling teeth instead of waiting maybe nine months between surgeries, which is a long time to go with missing teeth, is important for cancer survivors," said Evan Graboyes, M.D., a head and neck cancer surgeon.
Graboyes is part of a highly trained surgical team alongside Greer Albergotti, M.D., and Byung Joo Lee, D.D.S., a maxillofacial prosthodontist. The team was already highly proficient in ensuring that almost 100% of patients with head and neck cancer undergoing surgery to remove part of their jawbone left the operating room with endosteal implants, which later hold the artificial teeth, in their jawbone transplant. But they wanted to do more for people with head and neck cancer who've already been through so much, so the trio traveled to Dallas for specialized training in the Jaw in a Day procedure and waited for the right candidate to benefit from the procedure.
That patient was Tammy Duncan, a cancer survivor from Greenville, South Carolina, who developed osteoradionecrosis — dead bone caused by radiation — more than a decade after successful treatment for adenoid cystic carcinoma.
After two unsuccessful surgeries to remove dead bone, Duncan was referred to MUSC. The damage was too extensive, and her condition had progressed. Fortunately, she was a fit for the Jaw in a Day procedure.
Reconstructing a jaw — and a smile
In the 10-hour operation, the team removed the dead jawbone and replaced it with a piece of Duncan's fibula — the smaller bone in the lower leg. Before transplanting it, they inserted titanium implants into the fibula, attached custom-made teeth and shaped the new jawbone using precise 3D modeling and cutting guides.
The procedure required exceptional precision; virtual surgical planning was a critical aspect of the procedure, and every step was meticulously planned and executed. "Every millimeter mattered," Lee said.
While the fibula was still connected to its blood supply, the implants and teeth were secured. The bone was then transplanted into her jaw and connected to a new blood supply. A titanium plate was added to stabilize everything until the bone could fuse and heal.
After the surgery, Duncan woke up with a full set of "smiling" teeth — though she'll need time before using them to chew. "Being cancer-free is always the top priority," said Albergotti, "but helping patients come out of surgery as close to the best version of themselves as possible is also incredibly important."
A team effort
The Jaw in a Day procedure demands a high level of coordination. "You have to work together as a team," Lee said. "One or two surgeons alone can't pull this off." He explained that advanced imaging, cutting-edge modeling and in-house fabrication of implants and teeth make this level of precision possible.
Duncan's case also illustrates a growing focus on cancer survivorship — and the long-term impact of treatment. "We're thinking beyond the cure," said Graboyes, who leads Hollings' Survivorship and Cancer Outcomes Research (SCOR) program. "Jaw in a Day is a prime example of how a comprehensive interdisciplinary team approach can restore a patient's dignity, confidence and quality of life."
