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Buccal Mucosa Graft: What Happens to the Mouth After Urethroplasty?

Buccal Mucosa Graft: What Happens to the Mouth After Urethroplasty?

📖 5 min read Written/reviewed by Dr. Alhad Naragude, MBBS, MS, DrNB Urology Last updated: September 4, 2026

In buccal mucosal graft urethroplasty, a thin strip of lining is taken from the inner cheek and used to widen or reconstruct the urethra. The mouth usually heals quickly because oral mucosa has a rich blood supply. Soreness, tightness while opening the mouth, mild swelling and temporary numbness can occur during the first days. Most patients return to a normal diet progressively. Long-term troublesome mouth symptoms are uncommon, but they are possible, especially when a large graft or grafts from both cheeks are needed.

Why is tissue taken from the cheek?

Buccal mucosa is hairless, accustomed to a moist environment and has a robust surface layer with a relatively thin supporting tissue. These properties make it a widely used graft for urethral reconstruction. The graft is usually taken from the inner cheek, away from the opening of the parotid salivary duct.

What happens during the first weeks?

Time What you may notice
First 24-48 hours Cheek soreness, swelling, mild blood-stained saliva and discomfort while chewing or opening the mouth.
First week Pain usually improves; eating becomes easier. A pale healing surface can be visible if the donor site was left open.
2-4 weeks Most patients have much less tightness and can eat normally; residual numbness or altered sensation may persist.
Later months The donor site usually softens. Persistent tightness, numbness or salivary symptoms should be reviewed.

Is the cheek wound stitched closed?

It may be closed with absorbable stitches or left open to heal naturally, depending on graft size, surgeon preference and donor-site anatomy. Current evidence does not show a clear medium- or long-term advantage of routinely closing every donor site, so both approaches are accepted.

Eating and mouth care after surgery

  • Start with liquids or soft foods as advised and progress according to comfort.
  • Avoid very hot, sharp or highly irritating foods while the donor site is painful.
  • Maintain oral hygiene gently and follow the mouth-rinse instructions given by your surgical team.
  • Do not repeatedly stretch the cheek or pull on sutures.
  • Stay hydrated unless another medical condition requires fluid restriction.

Common donor-site symptoms

Pain or burning is common early and should improve. Cheek tightness or reduced mouth opening can occur while the scar heals. Altered sensation or numbness is usually temporary, although a small number of patients report persistent sensory change. Marked swelling around meals, persistent dry mouth or significant restriction in mouth opening deserves review.

What is normal in the mouth – and what is not

For the first several days, cheek soreness, tightness, mild swelling and discomfort with spicy or acidic food are common. A pale or yellow-white surface over the wound can be part of normal healing and is not automatically pus. The mouth usually improves substantially over the first one to two weeks, although tightness, altered sensation or difficulty opening widely can take longer to settle.

Long-term donor-site problems are uncommon but can include persistent numbness, tightness, salivary-duct symptoms or limitation of mouth opening. Risk depends partly on how much mucosa is harvested and from where. When a very long graft is required, tissue may be taken from both cheeks and occasionally the lower lip, but the surgeon plans the harvest to avoid the parotid duct and preserve function.

Patients should report increasing rather than improving swelling, persistent bleeding, fever, foul discharge, inability to maintain oral intake or significant difficulty opening the mouth. Tobacco and smokeless tobacco impair oral healing and should be avoided around surgery. Mouth care instructions vary by surgeon; the important point is gentle hygiene and adequate hydration rather than aggressive scrubbing of the donor site.

When should the mouth be reviewed urgently?

  • Bleeding that does not settle with the measures advised by your team.
  • Rapidly increasing cheek or neck swelling.
  • Breathing or swallowing difficulty.
  • High fever with increasing mouth pain, foul discharge or worsening swelling.
  • Inability to drink enough fluids because of pain or vomiting.

Can buccal mucosa be taken again?

Sometimes another oral site can be used if redo reconstruction is required. The opposite cheek, residual cheek mucosa or lingual mucosa may be considered. Previous graft size, scarring, dentition and mouth opening are assessed before repeat harvest.

What to bring for follow-up

  • Urethroplasty discharge summary.
  • A list of mouth symptoms: pain, numbness, tightness, eating difficulty or swelling.
  • Any photographs of a transient swelling or bleeding episode.
  • Details of tobacco use or significant oral disease.

FAQs

Will I have a visible scar on my face?

No external facial incision is normally required. The donor site is inside the mouth.

How long will mouth pain last?

Pain is usually most noticeable during the first several days and then improves. Duration depends on graft size and individual healing.

Will eating affect the urethral graft?

No. Diet advice is mainly for comfort and healing of the mouth donor site.

Is a special mouth rinse compulsory?

Use the regimen prescribed by your surgeon. Evidence that one particular rinse prevents donor-site pain or complications is limited.

Can tobacco affect healing?

Yes. Smoking and chewing tobacco can irritate oral tissue and impair wound healing.

Related reading

References

Note: This information is for educational purposes only and is not a substitute for medical advice. Please consult your doctor for any symptoms.