The fibula is the slimmer of the two bones in the lower leg. Surgeons can move a length of it, with its blood supply and sometimes a patch of skin, to rebuild a jaw or another missing segment of bone.
A fibula flap takes a section of the smaller lower leg bone together with the artery that feeds it. Surgeons cut the bone into segments, shape it to the curve of the jaw, fix it with plates and then join its vessels in the neck under a microscope. Because the bone stays alive, it heals and can later hold dental implants.
Two bones run between the knee and the ankle. The tibia carries almost all of the load, while the fibula sits on the outer side and acts mainly as an anchor for muscles and for the ankle joint. That difference is what allows a long piece of fibula to be borrowed for reconstruction, provided the segments near the knee and ankle are left in place.
Blood reaches the fibula through a vessel that runs alongside it and sends branches into the bone all the way down. Because supply comes from many small branches rather than one point, surgeons can cut the bone into two or three pieces, angle them, and each piece still receives blood. That is how a straight bone becomes the curve of a lower jaw.
A paddle of skin from the outer calf can travel with the bone when lining or external cover is also missing. The leg is then closed directly if the paddle is narrow, or resurfaced with a skin graft when it is wider, which leaves a visible patch on the outer calf.
It suits people who have lost a segment of bone and need living bone rather than a graft, and whose leg circulation can spare the fibula safely.
Scans of the jaw and the leg vessels guide the plan. Models or computer planning are sometimes used to work out where the bone cuts fall and how the plate will sit before surgery begins.
One team opens the neck and jaw, removes the affected segment with a safe margin and prepares an artery and a vein in the neck to receive the flap.
A second team works on the outer calf, freeing the required length of bone with its vessel and, when needed, a skin paddle, while leaving the ends near the knee and ankle untouched.
Bone is cut into angled segments and held to the remaining jaw with titanium plates and screws, restoring the outline of the lower face before the vessels are divided.
Vessels are joined in the neck under a microscope and flow is confirmed. Drains are placed, the leg is closed or grafted, and a splint supports the ankle.
Flap checks continue day and night. Feeding usually goes through a tube at first so the mouth can rest, and the leg is raised in a splint to control swelling.
Drains come out and mouth care begins in earnest. Standing and walking start with a physiotherapist and a frame, and any skin graft on the calf is inspected.
Bone healing is checked with imaging, and diet often moves from liquids towards soft food. Walking improves steadily, though the ankle may still feel stiff at the end of the day.
Once the bone has united, dental implants and a prosthesis can be planned. Scars soften on both the neck and the calf, and ankle movement keeps improving with exercises.
Facial shape and jaw continuity usually improve a great deal, and chewing can return once teeth are rebuilt. Speech and swallowing often need therapy, especially after radiotherapy. Some numbness of the lip and chin is common, and the reconstructed jaw rarely feels exactly like the original. On the leg, walking normally returns, although a scar, a numb patch and occasional ankle tightness remain for many people.
This is one of the longest reconstructive operations, and the risks span both the head and the leg.
Two very different areas heal at once, so the routine covers the mouth and neck as well as the leg.
The tibia carries the load. Most people walk unaided once healing is complete, though ankle stiffness and a scar can remain.
Bone must unite first. Implants and a prosthesis are usually planned as separate stages months later, guided by imaging and dental review.
A plate without living bone tends to loosen, break or become exposed over time, especially after radiotherapy.
Shape and support improve markedly, yet contour, sensation and movement differ from the original jaw.
Elegance Clinic in Surat plans jaw reconstruction with the eventual teeth in mind, not just the bone. Families hear the full sequence of stages, with timing and cost, before the first operation is booked.
A technique page carries no price of its own, because cost follows the treatment the fibula flap is used within. Jaw reconstruction after cancer involves different theatre time, plates, hospital stay and dental stages compared with repair of a long bone gap.
After assessment you receive a written estimate covering each planned stage, and the related treatment page shows the usual band.
These are the questions that come up most often in consultation. If yours is not here, send it on WhatsApp and the team will reply, usually the same day.
Ask your question →Price belongs to the treatment rather than the technique. Theatre time, plates and screws, hospital stay, imaging and later dental work all contribute. A written estimate covering the planned stages is prepared once assessment is complete.
It is considered safe when scans show the leg has its normal three arteries and the segments near the knee and ankle are left alone. Where circulation is doubtful, a different donor site is chosen instead.
Recovery can vary widely. Early days are spent under close flap monitoring, followed by weeks of walking practice, mouth care and gradual diet progression. Bone healing and dental rehabilitation continue over many months.
Chewing usually improves once bone has united and teeth have been rebuilt on implants or a prosthesis. How much returns depends on how much jaw was removed, on radiotherapy and on tongue and lip movement.
People with poor leg circulation, an earlier leg fracture, ongoing tobacco use, unsettled diabetes or active infection may be advised against it. Those needing only a small gap filled are often better served by a simpler graft.
Reconstruction is commonly carried out at the same sitting as tumour removal, so the jaw is restored immediately. Sometimes it is delayed until margins are confirmed or until radiotherapy planning is settled by the wider team.
The jaw and mouth are examined, the leg pulses are checked and imaging is arranged. Alternatives, risks, the number of stages, dental options and the estimate are explained so the whole path is clear before any decision.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
