Mandibulectomy: Types, Procedure, Recovery, and What to Expect
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is a mandibulectomy?
Mandibulectomy is surgery that removes a small or large part of the lower jawbone (mandible), most often to treat cancer of the mouth or throat. A partial (marginal) mandibulectomy removes part of the bone, while a segmental mandibulectomy removes a full section, which is usually rebuilt with bone from the lower leg. [1]
What the research says
Rebuilt jaws using leg bone usually take well. A review of 78 studies covering 2,461 patients found an overall flap success rate of 93% when the jaw was rebuilt with a vascularized fibula flap, with no significant difference between rebuilding at the same operation or later (Awad et al., J Craniomaxillofac Surg, 2019). [2]
The fibula had the lowest failure rate in damaged, irradiated jaws. In 19 studies (397 patients, 424 flap procedures) of jaw reconstruction for radiation-related bone death, fibula flaps failed in 3.3% of cases, while the pooled complication rate across all flap types was 22.5% (Farsi et al., Am J Otolaryngol, 2025). [4]
Evidence comparing the two surgery types is still limited. A review of 15 retrospective studies (11 pooled in a meta-analysis) found a difference only in 5-year disease-free survival, with a trend favoring segmental surgery when cancer had invaded the inner bone marrow (Chiesa-Estomba et al., Int Arch Otorhinolaryngol, 2023). [3]
Key takeaways
Mandibulectomy removes part of the lower jaw, mainly to treat oral and throat cancers. [1]
There are two types: partial (marginal) and segmental. [1]
Segmental surgery is usually followed by jaw reconstruction, most often with a free fibula flap from the lower leg. [1]
Most people stay in the hospital for one to two weeks and relearn eating and speaking with therapy. [1]
Many people return to work after several weeks, but radiation therapy can lengthen recovery. [1]
What is a mandibulectomy?
A mandibulectomy (MAN-dih-bul-EK-toh-mee) is an operation that removes a small or large part of the lower jawbone, also called the mandible. [1] It is also known as mandibular resection. [1]
Surgeons usually perform it to remove a tumor or a diseased section of the jaw. [1] It is a major operation that takes many hours under general anesthesia. [1]
After the bone is removed, the surgeon may rebuild the jaw using bone or soft tissue from another part of the body. [1] This is called free-flap reconstruction. [1]
Who needs a mandibulectomy?
A mandibulectomy is used for people whose jawbone is affected by cancer, infection, serious bone disease, or major injury. [1] The most common reasons are listed below.
Reason | What it means |
Mouth cancer | Cancer in the mouth that affects the jaw [1] |
Oropharyngeal cancer | Cancer in the middle part of the throat [1] |
Jawbone infection | Infection in the jawbone [1] |
Osteonecrosis of the jaw | Bone death linked to some cancer medicines [1] |
Osteoradionecrosis | Bone death caused by radiation therapy [1] |
Severe jaw injury | Significant trauma that damages the jawbone [1] |
To learn more about these conditions, read our guides to oral cancer, jaw cancer, oropharyngeal cancer, osteonecrosis of the jaw, osteoradionecrosis, and osteomyelitis (bone infection).
What are the types of mandibulectomy?
The two types of mandibulectomy are partial (marginal) mandibulectomy and segmental mandibulectomy. [1] The main difference is how much bone is removed and whether the jaw needs to be rebuilt.
Marginal surgery keeps the jawbone in one piece; segmental surgery removes a full section that is then rebuilt.
Feature | Partial (marginal) mandibulectomy | Segmental mandibulectomy |
Bone removed | Only part of the jawbone [1] | A large part of the jawbone [1] |
Reconstruction | May not be needed [1] | The jaw is rebuilt [1] |
Usual rebuilding method | Not applicable | Free fibula flap: bone, an artery, a vein, and soft tissue from the lower leg [1] |
Typical approach | Incision through the inner cheek [1] | Tumor removal, lymph node check, then reconstruction [1] |
The type you need depends on several factors, including how far the cancer has spread into the jawbone. [1] Your general health and personal preferences also matter. [1]
Research comparing the two types is based on retrospective studies, so the choice is made case by case. [3]
How do you prepare for a mandibulectomy?
Preparing for a mandibulectomy starts with imaging tests, such as a CT scan and MRI, to evaluate the affected area. [1]
If your jaw will be rebuilt, your care team will also check the health of the blood vessels at the donor site, the body part the bone will come from. [1]
Your team may suggest changes to your eating habits and exercise to get you in good shape for surgery. [1] You may also need to avoid substances that can cause bleeding or slow healing. [1]
Substances you may be asked to avoid include: [1]
Alcohol
Aspirin, naproxen, or ibuprofen
Herbal supplements
Tobacco
What happens during a mandibulectomy?
During a mandibulectomy, you receive general anesthesia so you are asleep for the whole operation, which takes many hours. [1] Your care team places an IV for nutrition and pain medicine, a urinary catheter, and a breathing tube. [1]
Marginal mandibulectomy steps
During a marginal mandibulectomy, the surgeon: [1]
Makes an incision through the inner cheek
Removes the tumor and the surrounding soft tissue from the lower jaw
Closes the incisions
Segmental mandibulectomy and reconstruction steps
During a segmental mandibulectomy, the surgical team removes a larger portion of the jaw and then rebuilds it. [1] These two parts often happen back to back, but sometimes on different days. [1]
The seven main steps of segmental mandibulectomy with free fibula flap reconstruction.
Typically, the team: [1]
Removes the tumor and surrounding tissues
Sends the tissue to a lab to test for cancer cells
Checks whether cancer has spread to the lymph nodes
Removes bone, tissue, and skin from the donor site, usually the fibula
Shapes the bone to match the missing piece of jaw
Connects the donor artery and vein to an artery and vein in the head and neck
Attaches the new jaw with plates and screws, then closes the incisions
Your provider may also place dental implants on the day of surgery. [1] Other rebuilding options include bone from the shoulder blade or hip, a metal plate, or donor bone. [1]
What are the risks and benefits of a mandibulectomy?
The main risks of a mandibulectomy are those of any major surgery: blood or fluid buildup under the skin, blood clots, infection, and nerve damage. [1] These complications are not common. [1]
Possible risks | Possible benefits |
Blood or fluid buildup under the skin [1] | Removal of the cancer [1] |
Blood clots, such as deep vein thrombosis [1] | Ability to keep eating and talking after reconstruction [1] |
Infection [1] | More confidence about appearance [1] |
Nerve damage [1] | Improved quality of life for most people [1] |
Studies of jaw reconstruction support the fibula as a reliable donor bone, with a 93% overall flap success rate across 2,461 patients. [2] In jaws damaged by radiation, fibula flaps had a 3.3% failure rate. [4]
What happens after a mandibulectomy?
After a mandibulectomy, most people wake up in the intensive care unit (ICU) with drains in the jaw and at the donor site to help the wounds heal. [1] You may need an oxygen mask to help you breathe. [1]
Once you are stable, you move to a regular room. [1] Most people stay in the hospital for one to two weeks, depending on the procedure. [1]
Recovery moves in stages, from the ICU to home, with clear warning signs to watch for.
How long does mandibulectomy recovery take?
Mandibulectomy recovery takes time, starting in the hospital and continuing at home. [1] While you are in the hospital, your care team helps you with three key areas.
Area | What to expect |
Communicating | You may not be able to speak at first, so you may use a writing pad or answer yes-or-no questions [1] |
Eating | You are fed through a tube in the nose or belly, then move to liquids and later soft foods [1] |
Moving | Walking, when safe, helps healing, prevents blood clots, and helps avoid constipation [1] |
Many people start physical therapy and speech therapy in the hospital and continue after going home. [1] These therapies help you eat, swallow, and speak again. [1]
At home, follow your provider's instructions for eating and caring for your incisions. [1] Soreness, tightness, or heaviness in the jaw for several months is not unusual, and for most people the pain slowly eases into discomfort before going away. [1]
How does a mandibulectomy affect eating?
A mandibulectomy affects eating because the surgery involves the muscles attached to the jaw, including the chewing muscles. [1] These muscles need time to heal, which is why a feeding tube is often needed at first. [1]
You will likely work with a healthcare provider to retrain these muscles. [1] Progress can feel slow and frustrating, but with practice and patience many people move from liquids to soft foods and then back to regular meals. [1] If swallowing is a problem, our guide to dysphagia (trouble swallowing) explains what can help.
Dental rehabilitation can also make a difference. A review of 7 studies of people who had partial mandibulectomy found that quality of life improved after prosthetic rehabilitation, with better chewing, speech, and social life. [5]
When can you return to work after a mandibulectomy?
Most people can return to work several weeks after a mandibulectomy. [1] Strenuous activities, such as exercise, may need to wait longer. [1]
A physically demanding job usually takes longer to return to than a desk job. [1] Many people also have radiation therapy after surgery to destroy any remaining cancer cells, which can lengthen recovery. [1] Your surgical team will tell you when it is safe to resume your routine. [1]
When should you call your healthcare provider after a mandibulectomy?
You should call your healthcare provider after a mandibulectomy if you develop any of these warning signs: [1]
Fever above 100.5°F (38.05°C)
Increased bruising
Nausea or vomiting
Severe pain that does not improve with a pain reliever
Shortness of breath or trouble breathing
Swelling, warmth, or bad-smelling drainage at the incision
If breathing becomes difficult, seek emergency care right away.
Conclusion
A mandibulectomy is a major operation, but it is often the key step in removing cancer or diseased bone from the lower jaw. Partial surgery keeps the jaw in one piece, while segmental surgery removes a full section that is usually rebuilt with bone from the lower leg.
Recovery takes patience. Expect a hospital stay of one to two weeks, a gradual return to eating and speaking with therapy, and several weeks before work. Feeling anxious is normal, so ask your surgical team which type of surgery you need and what rehabilitation will involve.
Facing jaw surgery or supporting someone who is? Save this guide, share it with your family, and bring your questions to your surgical team. For more clear, evidence-based guides, explore the Diseases & Conditions library on Rinnit.com.
FAQ
What is a mandibulectomy?
Mandibulectomy is surgery that removes a small or large part of the lower jawbone (mandible). It is mainly used to treat cancer of the mouth or throat, and the jaw may be rebuilt afterward.
What is the difference between marginal and segmental mandibulectomy?
Marginal mandibulectomy removes only part of the jawbone, so reconstruction may not be needed. Segmental mandibulectomy removes a large section of the jaw, which is then rebuilt, usually with a free fibula flap from the lower leg.
Why would someone need a mandibulectomy?
Mandibulectomy is used for mouth cancer, cancer in the middle of the throat, jawbone infection, bone death from cancer medicines or radiation, and severe jaw injury. The goal is to remove the diseased or damaged bone.
How is the jaw rebuilt after a mandibulectomy?
The jaw is usually rebuilt with bone, an artery, a vein, and soft tissue from the fibula in the lower leg. Surgeons may also use bone from the shoulder blade or hip, a metal plate, or donor bone.
How long is the hospital stay after a mandibulectomy?
Most people stay in the hospital for one to two weeks after a mandibulectomy. The exact stay depends on the type of procedure and how recovery goes.
Can you eat normally after a mandibulectomy?
Many people eventually return to regular meals after a mandibulectomy. Eating starts through a feeding tube, then moves to liquids and soft foods as the jaw muscles heal and are retrained with therapy.
How long until you can go back to work after a mandibulectomy?
Most people return to work after several weeks. Physical jobs and follow-up radiation therapy can make recovery take longer.
When is a problem after mandibulectomy an emergency?
Shortness of breath or trouble breathing after a mandibulectomy needs urgent medical attention. Also call your care team for fever above 100.5°F (38.05°C), severe pain, increased bruising, nausea or vomiting, or swelling, warmth, or bad-smelling drainage at the incision.
Will I need a tracheostomy after a mandibulectomy?
Some people need a temporary breathing tube in the neck after larger jaw operations, especially when the jaw is rebuilt. It helps protect breathing while swelling goes down and is usually removed as you heal.
Will I need speech or swallowing therapy after a mandibulectomy?
Many people do. Speech and swallowing therapy often starts in the hospital and continues at home to help you eat, swallow and speak again.
Related Reading
Jaw Cancer: Symptoms, Types, Causes, and Treatment explains the types of jaw cancer and how they are treated.
Oral Cancer: Symptoms, Risk Factors, and Treatment Pathways covers mouth cancer warning signs, risk factors and treatment.
Floor-of-the-Mouth Cancer: Symptoms, Diagnosis, Treatment and Support explains cancer under the tongue and how it is treated.
Tracheostomy: Purpose, Procedure, Recovery and Living With a Trach describes how a breathing tube is placed in the neck and cared for.
References
Cleveland Clinic. Mandibulectomy: Definition, Procedure & Types. Cleveland Clinic. Last updated March 13, 2026. https://my.clevelandclinic.org/health/treatments/23455-mandibulectomy
Awad ME, Altman A, Elrefai R, et al. The use of vascularized fibula flap in mandibular reconstruction; A comprehensive systematic review and meta-analysis of the observational studies. J Craniomaxillofac Surg. 2019;47(4):629-641. PMID 30782453. https://doi.org/10.1016/j.jcms.2019.01.037
Chiesa-Estomba CM, Mayo-Yanez M, Manelli G, et al. Marginal versus Segmental Mandibulectomy in the Treatment of Oral Cavity Cancer: A Systematic Review and Meta-analysis. Int Arch Otorhinolaryngol. 2023;27(4):e733-e743. PMID 37876698. https://doi.org/10.1055/s-0042-1750764
Farsi S, Benafield A, Dorman J, et al. Outcomes of free flap reconstruction for mandibular ORN: Systematic review and meta-analysis. Am J Otolaryngol. 2025;46(1):104508. PMID 39580338. https://doi.org/10.1016/j.amjoto.2024.104508
Shankar RK, Raza FB, Kumar VA. Quality of Life with the Rehabilitation After Partial Mandibulectomy: a Systematic Review. Indian J Surg Oncol. 2023;14(2):292-300. PMID 37324294. https://doi.org/10.1007/s13193-022-01664-x
Disclaimer
This article is for general education only and does not replace advice from your doctor or surgical team. Decisions about mandibulectomy, reconstruction, and recovery depend on your individual situation. If you have urgent symptoms such as trouble breathing, seek emergency care immediately.
Comments