Learn more about facial prosthetics after head and neck cancer treatment. Watch video.

Changes in appearance

What will I look like?
Treatment for head and neck cancers can affect your face, sometimes resulting in dramatic changes to how you look. And unlike other types of cancer, the scars and side effects of treatment are very visible and can’t be hidden. It may take time to adapt to these changes and it can affect your self-esteem.

To successfully remove tumours surgeons sometimes need to remove tissue and bone from the face. In some cases, they will use tissue and bone from other parts of the body to reconstruct the face. In others, the patient will have to adjust to a new life with a facial disfigurement. There will be swelling and bruising after surgery so it may be a while before you see the final result.
 
Other treatments like radiation therapy and chemotherapy can result in burnt tissue, redness and inflammation.
 
It can help to have someone with you when your dressings come off after surgery. Be prepared for a shock. It will be different to how you are used to seeing yourself. A change in appearance can have an impact on your body image and it can take time to get used to. You may feel disorientated, distressed or embarrassed as you get used to your new looks, even if it’s not that noticeable to others.
 
In some cases, you will go through a number of changes in appearance. It could be that your surgeon removes the disease first, then uses bone, skin and muscle grafts to restore function and appearance. Discuss these stages thoroughly with your surgeon so that you know what to expect at each step of the way.
 
You may be offered a prosthesis and you can also talk to your doctor about camouflage makeup.
 
After a change in appearance, it’s important not to avoid looking at yourself. This is how you will get used to your new face. It can be helpful to talk about the experience and get emotional support from those around you or join a support group.
 
Ask your doctor for details on counselling and psychological support. Many head and neck services have clinical nurse specialists available to help. Visit our Find Support page for more information.
 
What if I need a prosthesis? 
If you have had major facial surgery you may need a prosthesis. A prosthesis is an artificial part used to replace a missing part of the body. It can be used to restore function to a part of the body and can help improve cosmetic appearance and improve confidence.
 
Two types of prostheses are commonly used in head and neck surgery.
 
1) Obturator
An Obturator goes into the mouth. These are used when someone has had surgery to remove part of their upper jaw, and may be used to recreate the palate, the top part of the mouth and the upper jaw so that they can speak and eat properly.
 
2) Facial Prosthesis
A facial prosthesis is used to replace a part of the surface of the face. These are made for someone who has lost either an ear, nose or eye following cancer surgery. This is very uncommon, but when needed, these prostheses can be made of very realistic materials, such as Silicone, and are very convincing. They are matched to the surrounding skin tone and can include features like freckles.
 
Your prosthetist will instruct you on care of your prosthesis. Click here to learn more about facial prosthetics.

What about make up?  
Camouflage creams and makeup may be an option for covering up scars and blending in prostheses. These are specially designed for use by both men and women. Ask your doctor for more information.
 
Living with a facial disfigurement
Having a facial disfigurement can affect you in three ways: physically, emotionally and socially.
 
Physical
A facial disfigurement may result in difficulty chewing and swallowing, breathing, speaking, seeing or hearing.
 
Issues with chewing and swallowing can greatly impact your social life as meeting over a drink or a meal is so central to how we socialise. Some feel embarrassed about eating in front of others if they struggle with swallowing. You may not enjoy food as much as you used to if you sense of taste is affected.
 
Keeping social is important to avoid feelings of isolation and depression. Friends and family are much more likely to want to spend time with you than to have an issue with your physical difficulties. If it is too much of a struggle, maybe you can eat before you join others and still enjoy an evening out with them.
 
If your speech has been affected, you may need to find new ways to communicate which can be frustrating. Again, it’s important not to avoid social situations as they help maintain normalcy in your life.
There are things you can do to get your message across. Speak slowly and clearly and look at people when you are talking. Find a quiet place to talk and use your eyes, hands and face to express meaning.
 
You can seek help from a speech pathologist who is an expert in difficulties with communication and swallowing.
 
For more information, see speech and swallowing.
 
Emotional – adjusting to a new normal
Adapting to the change in how you look can be more challenging and traumatic for some people than the change in body function.
 
We look to a person’s face to understand their feelings. If your face is disfigured it affects your body image and self-esteem, it can make you feel self-conscious and unconfident. Some people feel anxious about social interactions as they are unsure about how others will react.
 
Some people find approaching social situations confidently is a good way to influence how others react to you. People react better to someone who is positive and confident.
 
Strategies to help you cope include learning how to appreciate yourself and seeing yourself as a whole person rather than the part that has changed.
 
Seeking emotional and psychological support is invaluable. Your doctor or nurse can connect you to counselling services and support groups. Visit our Find Support page for more information.
 
Social – other people’s reactions
When you are ready for other people to see what you look like, it’s helpful to remember that they may feel the same shock you did the first time they see you. But they will become more and more familiar with your appearance over time and will understand that you are still the same person as ever.
 
It’s common to worry that you are no longer attractive and particularly that your partner won’t find you attractive. The best way to deal with this is to talk about these feelings. It may be that they were worried that you were thinking this but didn’t know how to reassure you.
 
Although it may seem that society places high importance on physical appearance, real friendships and relationships are not superficial. They are based on personality, trust, shared experiences, common interests and sense of humour, among other things. These don’t depend on your looks.
 
You might feel self-conscious about people you know less well. The key to feeling confident is to take the initiative. Prepare a response in advance to the occasional insensitive question and make the first advance. If you approach someone confidently and openly, they are likely to respond in kind.
 
It’s important not to let your disfigurement isolate you. Rewarding social relationships will help you get through feelings of depression, anxiety and isolation.