What Are the Different Types of Oral Cancer Surgery?

Written by Keri Wiginton
Medically Reviewed by Laura J. Martin, MD on July 01, 2025
11 min read

Oral cancer surgery refers to a group of procedures with different jobs: removing cancer, rebuilding areas affected by treatment, or restoring key functions like eating, speaking, or swallowing. It’s usually the first treatment doctors suggest, especially when the tumor can be removed completely. 

“A good amount of patients that have surgery do go on to have radiation and maybe chemotherapy, but we always start with surgery – it has the best cure possibility,” says Ansley Roche, MD, head and neck oncologic and reconstructive surgeon with Smilow Cancer Hospital. 

Oral cavity (mouth) cancer may include: 

  • Lips 
  • Tongue
  • Cheeks
  • Roof of mouth (hard palate)
  • Floor of the mouth (under the tongue)
  • Gums

You may also need surgery on nearby areas like the salivary glands, lymph nodes in the neck, or your throat. But if the cancer starts in the part of the throat right behind your mouth, including the tonsils, it's called oropharyngeal cancer, and your treatment plan may be different. There are several types of throat cancer – oropharyngeal, nasopharyngeal, hypopharyngeal, and laryngeal cancer.

What kind of doctor treats oral cancer?

Mouth and throat cancers are best treated by an expert in head and neck cancer surgery. That’s someone who specializes in this area and performs these operations regularly. Studies suggest people may live longer when treated at high-volume centers with experienced teams. 

“If you have to wait an extra few days or even a week for your appointment, it’s always better to see a specialist first,” says Caitlin McMullen, MD, a head and neck surgeon with the Department of Head and Neck-Endocrine Oncology at Moffitt Cancer Center.  

If you don’t have one nearby, consider traveling to a larger hospital or cancer center for care. 

If you look at your mouth in a mirror, you’ll notice it isn’t just one thing. It has many parts, each with a unique role. 

“The tongue is mobile. It creates bulk. It helps move food around. It helps you talk,” Roche says. “The cheeks are sort of like a sheet of tissue. The alveolar ridge – where our teeth are – that’s how we chew.” 

 Doctors call these areas “subsites.” Each one is made of different tissue and may need its own type of surgery. Your care team will tailor your operation to the tumor’s size and location. They’ll also consider how removing cancer affects each part of your mouth.

You may need one or more of the following: 

Tumor resection 

This is surgery to remove the cancer. Doctors take out a little healthy tissue around the tumor, called a margin, to make sure it’s all gone. The type of resection you need depends on where the cancer is growing.  If the cancer is large or has spread to nearby structures like bone or muscle, your surgeon may need to do a more complex procedure. 

Neck dissection (lymph node removal)

Oral cancer often spreads to lymph nodes in the neck. Your surgeon will likely remove some or all of them during surgery to remove the tumor. 

“If we know [cancer] is in there, we don’t just pick a couple out,” McMullen says. “We clean out as many lymph nodes as we can possibly find, from under the jaw on to the clavicle.”

Even if the nodes don’t look cancerous on scans, your doctor may still take some out to be safe. Testing them helps show whether the cancer has spread and what treatment you’ll need next. 

In early-stage cases, your surgeon may do a procedure that removes just a few key lymph nodes closest to the tumor (called sentinel lymph node biopsy). If those are clear, that’s a good sign the cancer hasn’t spread. 

Reconstructive oral cancer surgeries

These surgeries rebuild parts of your mouth, throat, jaw, face, or neck affected by cancer. After removing the tumor, your doctor may move tissue or bone from another part of your body (like your leg, arm, or wrist) to repair the area. 

“We have a reconstruction principle where we replace like with like,” Roche says. “So if we just remove soft tissue, we replace it with soft tissue. If we remove bone, we replace it with bone.” 

If you’re having only a small part of your tongue or cheek removed, those areas often heal well with stitches. But if you do need reconstruction, it usually happens during the same surgery that removes cancer. 

Surgery to restore body function

These procedures  help you eat, speak, or breathe more easily after cancer treatment. Not everyone needs them, but they can make a big difference if treatment affects important areas.

“Sometimes we need to provide a new way to swallow or get nutrition,” McMullen says. “That’s where feeding tubes or tracheostomy come in.” 

Your care team will help you figure out what support you need to feel and function your best during and after recovery. 

The goal is to help you look and feel like yourself while keeping key functions like chewing, swallowing, and speaking. Depending on the area and type of tissue removed, your doctor may use one or more techniques, including: 

Free flap reconstruction. Also called free tissue transfer, surgeons take a piece of your own tissue (along with the blood vessels) and move them to the area where the cancer has been removed. Your surgeon will sew the blood vessels to the ones near where the tumor was removed to keep the new tissue alive.

Bone grafts. If part of your jaw is removed, your surgeon may rebuild it with bone from your hip or leg (usually the fibula). These grafts help restore the shape of your face and give your mouth the support it needs to work. You may get a free flap surgery at the same time. 

Skin grafts. This uses thin layers of skin from another part of your body to fix surface areas, such as your lips or cheeks. They're often used when you don’t need muscle or bone, just skin to cover the wound.  

Obturators. These are special custom-made prostheses that fill spaces in the roof of your mouth or upper jaw.  They can help close openings left by cancer surgery and make it easier to speak or eat.  

After reconstructive surgery, recovery may include: 

  • A hospital stay of up to a week
  • Speech or swallowing therapy
  • Special meals or a feeding tube while your mouth heals

You’ll also need regular checkups with a head and neck cancer team that may include plastic surgeons, ENT specialists, and rehab experts. 

You may need extra support to eat, speak, or breathe while you heal. Restorative procedures can help manage these changes. They’re often temporary but may be long-term depending on the type of surgery and how your body recovers. 

Feeding tubes

These deliver food and medicine if it’s not safe to eat or swallow. You may need one for a short time while your mouth heals or longer if treatment affects your ability to swallow.  “For some people, it’s as short as a couple of months,” Roche says. “And then for other people, it could be indefinitely.” 

Common types include: 

Nasogastric (NG) tube. This is a thin tube that goes through your nose and into your stomach. It’s usually short-term (one to two weeks). Bypassing your mouth helps prevent infection while any wounds or reconstructive tissue heals. 

Gastrostomy (G) tube. A doctor inserts a G-tube through the outside of your belly directly into your stomach. This surgery is called a percutaneous endoscopic gastrostomy (PEG). You may have a G-tube (also called a PEG tube) for a few months or longer. 

Tracheostomy

If swelling or bulkiness from surgery makes it hard to breathe through your mouth or nose, your doctor may make a small hole in your neck (called a stoma). You’ll breathe through this opening until your airway is clear and safe again.

Dental extraction and implants

You may lose some teeth during surgery, or your doctor may have to remove them before you start radiation. If your teeth are taken out, dental implants may be an option to restore how you chew and smile. But they can be expensive and aren't often covered by insurance. 

“It’s actually quite uncommon, unfortunately, for patients to get good dental restoration because of the cost,” McMullen says.

If you have oral cancer, you may need one or more of the following: 

Glossectomy (tongue removal) 

This is one of the most common oral cancer surgeries. Your doctor may only need to remove part of your tongue (partial glossectomy). For large cancers, they may need to take out the whole thing. “That’s called a total glossectomy, and it’s a very big surgery,” McMullen says.

If your doctor takes out your entire tongue, you’ll need more intensive rehab and reconstruction to help you eat and speak again. But most people do well with the right care and support. 

Buccal resection

If cancer starts in the inner cheek lining (called the buccal mucosa), your surgeon may remove part of this soft tissue. This surgery is often done through the mouth and closed with stitches. But if the tumor goes deep, you might need a more involved procedure, possibly with reconstruction using a skin graft.

Mandibulectomy (jawbone removal) 

If cancer spreads into your jaw (mandible), your surgeon may remove part or all of the bone. Also called a mandibular resection, how much they need to take out depends on the size and location of your tumor. 

Maxillectomy (upper jaw/roof of mouth removal)

Doctors do this if you have cancer in the upper gums or hard palate. This surgery may leave a hole in the roof of your mouth. A prosthodontist can make a special prosthesis, or artificial body part, to fill the space. Or your surgeon may rebuild it with tissue from your arm or thigh. 

Mohs micrographic surgery

This precise surgery is often used for small cancers on the lip. The surgeon removes the tumor in very thin layers, checking each one under a microscope until no cancer remains. This method can save more healthy skin and leave a smaller scar, but it takes longer and requires a specially trained surgeon. 

Trans-oral robotic surgery (TORS)

This minimally invasive surgery uses robotic tools to remove tumors through the mouth. TORS can be a good choice for tumors in hard-to-reach areas and may lead to a quicker recovery with fewer side effects compared to more involved procedures. 

Laryngectomy (voice box removal)

This is a rare surgery for mouth cancer.  But if a tumor grows near the base of your tongue or invades your throat, your doctor may need to remove your voice box (larynx).  

After surgery, you’ll breathe through a small opening in your neck. You won’t speak the same way, but speech therapy and special tools can help you learn new ways to communicate. 

After surgery, you’ll likely have a bandage and a small drain to collect fluid. Most people stay in the hospital for a few days, sometimes up to a week, depending on how much was done. 

It’s normal to feel stiff or sore in your neck and shoulder. You might notice some swelling, tightness, or numbness near the area where the lymph nodes were taken out. These effects tend to get better as you heal, but some changes (like reduced shoulder range of motion) can linger. Physical therapy can help. 

There’s a nerve in your upper neck that helps control the corner of your mouth when you smile. During surgery, doctors often need to cut through a thin surface muscle to reach the lymph nodes, which can affect that nerve. 

“It’s actually quite common for people to have a slightly crooked smile afterwards, but usually that improves with time,” McMullen says. 

Your care team will monitor your recovery and show you how to manage any side effects. 

General risks of any surgery include:  

  • Pain
  • Bleeding or blood clots
  • Infection
  • Reaction to anesthesia
  • Pneumonia

With bigger surgeries, you may have:  

  • Slow or difficult healing
  • Trouble eating, breathing, or speaking
  • Changes in how you look (especially if bones are removed) 

Rarely, you may have more serious problems. Call your doctor right away if notice: 

  • Bleeding that doesn’t stop or gets worse
  • Redness, swelling or fluid coming from the area where you had surgery  
  • Pain that gets worse or isn’t controlled with medication
  • Fever or chills 
  • Trouble breathing or feeling short of breath
  • One arm or leg that’s swollen, red, warm, or painful
  • Trouble eating or drinking enough
  • Not being able to pee, or changes in your urine

Choosing a surgeon who has experience with head and neck cancer can make a big difference in lowering your risk and supporting your recovery. 

Most people feel tired, sore, and swollen for a few days or longer after surgery. Eating and drinking may be harder at first, especially if you had surgery on your tongue, jaw, or throat. 

Short-term side effects may include:

  • Pain or discomfort
  • Fatigue
  • Swelling in the face or neck
  • Trouble chewing or swallowing
  • Shoulder stiffness or weakness 
  • Numbness near the surgical site

Long-term side effects from oral cancer surgery may include: 

  • Difficulty with speech or swallowing
  • Loss or change of taste
  • Trouble moving your tongue
  • Ongoing shoulder pain or facial nerve issues (more common after neck dissection) 

Rehabilitation, speech therapy, physical therapy, and support from your care team can help you manage these changes and improve your quality of life. 

There are many types of oral cancer surgery. Some focus on removing the tumor. Others rebuild parts of the mouth or support important things like eating, speaking, or breathing. What you need depends on where the cancer starts, how big it is, and how far it spreads. 

Treatment can be complex. A skilled head and neck cancer surgical team, physical therapy, personalized rehab, and follow-up care can help you recover and adapt to any changes. 

What’s the survival rate for oral cancer after surgery?

If the tumor stays in the mouth, the 5-year survival rate ranges from about 73% to 94%. That rate drops if the cancer cells spread to other parts of the body.  

Do you stay in the hospital after mouth cancer surgery?

If you have only a small piece of your tongue or cheek removed, you may be able to go home the same day. But most people stay in the hospital for a few days up to 1-2 weeks, depending on how complex your surgery is. 

What’s the life expectancy after a glossectomy?

It depends on the stage and size of the cancer. For early-stage tongue cancer treated with a partial glossectomy, the five-year survival rate is usually around 85% to 91%. If the cancer spreads or comes back after treatment (recurrence), outcomes are more serious. 

What foods should you avoid after oral cancer surgery?

While you heal, you’ll likely want to avoid anything spicy, acidic, or hard. Soft foods are usually easier to handle. A dietitian can help you figure out what to eat during and after recovery.  

What can you do beforehand to help with oral cancer surgery recovery?

If you smoke, quit. Maintain a healthy weight. To stay nourished, focus on a diet rich in whole foods like fruits, vegetables, nuts, beans, and whole grains. Skip ultra-processed foods high in sugar, salt, and fat. Try to avoid or limit alcohol use.