There’s a lot to consider when you’re facing tumor removal surgery. Think about mandible or jaw surgery, for example. Your face is part of every interaction you have, how you express yourself, eat, and speak. The ability to smile naturally, sip from a glass without thinking about it, or even feel a loved one’s kiss on your lips is something most people take for granted. That is, until those abilities are altered.
Surgeons often focus on removing the tumor and reconstructing the bony structures of your face, whether that means using bone from another part of your body or inserting metal plates. But something that often gets left out of the conversation is your nerves.
Nerves run throughout your jaw (and every other part of your body), providing sensation to your lips, chin, and mouth. They are responsible for the subtle, unconscious functions you rely on daily, like feeling food on your lips, knowing when you’ve drooled, or avoiding biting your lip. However, these nerves are removed or damaged in many mandible surgeries, sometimes permanently. If they are not repaired, you may be left with permanent numbness, an issue that can significantly impact your daily life long after the surgical scars have healed.
Most patients don’t realize that nerve damage is a common side effect of many kinds of tumor removal surgery or that nerve repair is an option. This lack of awareness means that many people wake up from jaw reconstruction surgery only to discover that they can no longer feel their lower face. Some patients adapt over time, but others struggle with speech, drooling, and the loss of fine motor control in their lips and mouths.
Nerve repair is a surgical technique that can help prevent these long-term effects, but because it takes longer to heal and isn’t considered standard practice by all surgeons, it’s often overlooked. Understanding the role of nerves in your recovery—and asking the right questions before surgery—can make all the difference in preserving not just how you look but also how you feel.
What Happens When a Nerve is Cut?
Think about the last time you had a dental procedure where your mouth was numbed. You probably couldn’t feel your lip, chin, or maybe even part of your tongue. Drinking from a cup felt awkward, smiling seemed off, and your dentist probably told you not to eat until the numbness wore off, so you wouldn’t accidentally bite your lip.
Now imagine feeling that way permanently. During some surgical procedures, cutting a nerve to remove a tumor may be unavoidable. That’s certainly the case if part of your mandible or jawbone needs to be removed. That means you could face lifelong numbness in your lips and chin unless the nerve is repaired.
And it’s not just jaw surgery where nerves may be involved. Because nerves run throughout our bodies, nerve damage can happen in surgeries like mastectomies and with many common procedures like hip or knee replacements, limb surgeries, laparoscopy, and even C-sections. Yet many patients aren’t told that this could be a permanent side effect—or that nerve repair might be an option.
The Long-Term Impact of Nerve Damage
You may experience permanent numbness or chronic pain when nerves are cut. When you can no longer feel areas of the body that were once sensitive to the lightest touch, it can impact your connection with the world around you. In the case of jaw surgery, that may mean not being able to feel food or drink on your lips, making eating more difficult. Or even whether or not you are smiling.
When a nerve is damaged or left unrepaired, it can also cause the body to send signals to the brain, leading to chronic and sometimes debilitating pain. When a nerve is repaired, even if sensation is not fully restored, many patients avoid experiencing the chronic pain they might have felt if the nerve had not been repaired. These are long-term issues that surgeons don’t always discuss before a procedure. Not because they’re hiding anything, but because addressing nerves isn’t yet standard practice. With recent advances in care, repairing nerves is very possible and more surgeons and their patients need to advocate for it.
Nerve reconstruction techniques can help reconnect or address nerve damage, encouraging them to regenerate and restore more normal sensation or function over time. Unlike muscle or skin, nerves regenerate slowly—about 1 mm per day—so it can take time for feeling or function to return. While nerve reconstruction won’t always restore 100% of the original sensation, it can help patients regain their ability to go about their everyday lives more normally over time.
What You Can Do
Nerve repair should be part of the conversation no matter the type of surgery—particularly for tumor removal procedures where cutting nerves is common and unavoidable. Some degree of sensory nerve damage occurs in most surgeries, and in many cases, sensory nerve reconstruction isn’t feasible. However, it’s essential to discuss this significant topic. Many patients assume their surgeon will discuss all potential risks and solutions, but nerve reconstruction isn’t always standard practice. That means it’s up to the patient to ask the right questions.
Before surgery, ask your care team whether the procedure involves cutting any major nerves. If so, find out whether there’s an option to repair them. Simply bringing up the topic can open the door to a conversation about better long-term outcomes.
It’s also important to understand the lasting impact of nerve damage. Surgery is not just about removing a problem—it’s about giving patients the best possible long-term functional recovery. While some post-surgical side effects, like scarring, may be expected, the permanent loss of sensation is not something many people anticipate. Knowing what to expect in the months and years after surgery can help you make informed decisions about your treatment and recovery.
Ultimately, advocacy plays a crucial role in expanding access to advanced techniques. The more patients ask about nerve repair, the more likely it is to become a routine part of surgical procedures. Raising awareness about the risks of permanent numbness and the potential for recovery can help push the medical field toward more comprehensive solutions.
Surgery should not just be about survival—it should also be about preserving quality of life. And when it comes to nerves, the difference between repairing them and leaving them alone could mean a lifetime of feeling whole again.
BIO:
Dr. Patrick Garvey is a reconstructive microsurgeon with a specialized focus on advanced facial reconstruction, including the use of virtual surgical planning and 3D printing to optimize surgical outcomes. His extensive clinical outcomes research in areas such as rapid prototype modeling and preoperative vascular mapping has been published in landmark peer-reviewed journals and has shaped best practices in modern plastic surgery.
He currently serves as an Associate Professor of Plastic Surgery at The University of Texas MD Anderson Cancer Center in Houston, Texas, and as a Clinical Instructor of Plastic Surgery at Baylor College of Medicine. Dr, Garvey may be reached here.
