Procedure

Once the extent of bone to be removed is determined, an accurate template is made in 3 dimensions. This can be done preoperatively in selected cases and a 3D printed model based on scans.
Using the template, a similar length and shape of bone is then marked out on the appropriate donor site [this could be the leg, hip or elsewhere]
This bone is then carefully raised along with its blood vessels and overlying skin and soft tissue as needed. This is called a composite flap.
This flap is then inset into the defect and fixed with a titanium plate and screws. The skin and soft tissues are also inset as required
The blood vessels are then connected to similar calibre vessels in the neck region using ultra small sutures with the aid of magnification usually with a microscope.
The donor site is then closed or covered with a thin skin graft.

Reconstruction after Resection of the Jaw Bone (Mandible and Maxilla)