Mandibular Reconstruction — Principles of Segmental and Composite Defect Repair

This episode reviews the core principles of mandible and tongue reconstruction, focusing on functional restoration, flap selection, and three-dimensional reconstructive strategy.Topics include the goals of mandibular reconstruction, including scaffold restoration, oral competence, swallowing, lower facial projection, and prevention of the Andy Gump deformity. The episode also emphasizes the importance of dead space obliteration in contaminated head and neck defects to protect hardware, vessels, and soft tissue closure.Osseous reconstruction is reviewed through the major flap options, including the fibula free flap, scapula flap, and DCIA iliac crest flap, with discussion of the 6 cm rule, radiation considerations, vascularized bone, osteotomies, double-barrel fibula reconstruction, and donor-site morbidity.Tongue reconstruction is discussed using a function-based approach, comparing radial forearm free flap reconstruction for hemiglossectomy with ALT flap reconstruction for total glossectomy. Additional topics include sensate flap reconstruction, Allen test, chimeric flaps, OPAC flap design, virtual surgical planning, and “jaw-in-a-day” reconstruction.Part of Dr. Lara’s Plastic Surgery Compendium — a high-yield audio reference for plastic surgery trainees and surgeons. DisclaimerThis podcast is intended for educational purposes only and is designed for medical students, residents, fellows, and practicing healthcare professionals. It is not intended to provide medical advice, diagnosis, or treatment for any individual patient. The content presented reflects general surgical principles and should not be used as a substitute for formal medical training, clinical judgment, or consultation with qualified healthcare professionals. Listening to this podcast does not establish a physician–patient relationship.SEO / Topic Keywordsmandible reconstruction, tongue reconstruction, fibula free flap, scapula free flap, DCIA flap, iliac crest flap mandible, radial forearm free flap tongue, ALT flap glossectomy reconstruction, Andy Gump deformity, dead space obliteration, vascularized bone graft, double barrel fibula, OPAC flap, chimeric flap, virtual surgical planning, jaw in a day, oral cavity reconstruction, head and neck reconstruction