Free Flap Surgery


Restore appearance following surgery with the help of the free flap procedure.

Surgery is a common treatment for head and neck cancers. While often effective when abnormal growths are relegated to a single area, surgery usually involves the removal of skin and other tissues. Doing so can leave wounds that will need time to heal.

  • Some wounds and complex defects may be too large to naturally heal without leaving significant defects behind.
  • For situations like this, reconstruction may include a procedure known as free flap surgery.

What Is Free Flap Surgery?

Free flap surgery, also called free tissue transfer, is a reconstructive surgery technique that involves the transfer of skin from one area of the body to another. The tissue that’s being transferred is still linked to a major vein or artery. The transferred tissue is attached to an injured area via a graft or flap. The “flap” may only be fatty tissues. It could also contain some muscle from the area where the tissue was collected.

Who Might Need It?

Normally, surgeons make an attempt to keep incisions parallel to existing skin to minimize scarring and make it easier for tissues to heal following the removal of a tumor and other affected tissues. But if tissue loss is significant, it may be necessary to transfer skin from another location to correct the defect and restore function and appearance.

How Is It Different from a Skin Graft?

With a skin graft, a thin layer of skin is transferred from one area of the body to the location of the wound. However, the graft does not have its own blood supply. With a free flap procedure, the tissue’s blood supply in the form of an artery or vein remains intact and is transferred with the tissue to the wound site.

How Is It Done?

Free flap surgery is a type of microvascular surgery. During the procedure, the vein or artery of the flap is sewn into a matching artery or vein close to the wound site. The flap will retain its blood supply. The procedure is performed with precise and fine sutures under a microscope. Retaining the blood supply promotes tissue healing and facilitates the fusion of the transferred tissue into the tissues around the wound site.

Advantages for Patients

One of the main advantages of free flap surgery is the ability to restore appearance and function to larger areas. Also, free flap tissue does not naturally contract in the same way that skin graft tissue does. It can also be assumed with greater certainty that the transferred tissue will be healthy since it typically comes from an area far away from the tissues that were affected by cancer. Additionally, muscle, fat, skin, and nerves from the donor site can be more precisely matched to what’s around the wound site.

Free flap surgery can be performed on many different areas of the head, neck, and throat. In some instances, this reconstruction technique may be necessary following the removal of skull base tumors or larger growths that resulted in prominent defects. An ear, nose, and throat doctor specializing in cancer treatment can help patients determine what type of reconstruction surgery may be best for their situation.