A microvascular reconstruction procedure that moves tissue from one part of the body to rebuild areas affected by cancer removal or injury.
Overview
What is free flap surgery?
- A surgery used to rebuild areas after cancer removal or injury
- Tissue, skin, muscle, or bone is moved from one body part to another
- Tiny blood vessels are connected under a microscope
- Helps improve appearance and function
Why is free flap surgery done?
- To repair defects after head and neck cancer surgery
- To help with speaking, swallowing, breathing, and chewing
- To improve facial appearance and quality of life
- Sometimes used after trauma or non-cancerous tumours
Which cancers may need free flap surgery?
- Mouth cancer
- Throat cancer
- Voice box (larynx) cancer
- Nose and sinus cancer
- Salivary gland cancer
- Advanced skin cancers of the head and neck
Where does the donor tissue come from?
- Forearm
- Thigh
- Lower leg (fibula bone)
- Shoulder blade
- Back muscle
- Abdomen
What is a radial forearm free flap?
- Tissue is taken from the forearm
- Commonly used for mouth or throat reconstruction
- Helps restore speech and swallowing
What is a fibula free flap?
- Bone and tissue are taken from the lower leg
- Used to rebuild the jaw bone
- Strong enough to support dental implants
Procedure Overview and Preparation
How long does the surgery take?
- Surgery may take many hours
- Complex procedures can last up to 15 hours
- Two surgical teams may work together
What happens before surgery?
- Doctors examine overall health
- Blood vessels may be checked with scans
- Heart fitness and nutrition are assessed
What happens during surgery?
- Tumour is removed first
- Donor tissue is carefully taken
- Blood vessels are connected under a microscope
What happens after surgery?
- Doctors closely monitor blood flow in the flap
- Pain medicines and wound care are given
- Swelling and bruising are common initially
- Early walking helps recovery
Will I need a feeding tube?
- Some patients need temporary feeding support
- Helps maintain nutrition during healing
- Tube is usually removed once swallowing improves
Will I need a tracheostomy (trach)?
- Some patients need a temporary breathing tube
- Common after tongue, jaw, or throat surgery
- Usually removed once swelling decreases
How long is hospital stay after surgery?
- Most patients stay about 7 days
- Longer stay may be needed if complications occur
What therapies may be needed after surgery?
- Speech therapy
- Swallowing therapy
- Physical therapy for arm or leg strength
Benefits and Risks
What are the benefits of free flap surgery?
- Restores appearance and function
- Provides stable wound coverage
- Helps improve quality of life
- Low risk of donor site problems
What are the risks of free flap surgery?
- Blood clot in the flap vessels
- Infection
- Poor wound healing
- Flap failure
- Breathing or swallowing difficulties
Myths and Facts
Free flap surgery is only done for cosmetic reasons.
Free flap surgery mainly helps restore important functions like speaking, swallowing, breathing, and chewing after cancer surgery or trauma.
The transferred tissue will not survive in the new area.
Surgeons connect tiny blood vessels under a microscope to maintain blood supply and keep the tissue healthy.
Everyone will need a permanent feeding tube or tracheostomy.
Feeding tubes and tracheostomies are often temporary and removed once healing improves.
Recovery after free flap surgery is not possible.
Most patients regain good function and quality of life with proper rehabilitation, therapy, and follow-up care.
FAQs
Is free flap surgery painful?
Some pain and swelling are expected. Pain medicines help keep you comfortable.
How long does recovery take?
Initial recovery takes a few weeks. Complete healing may take several months.
Will there be scars?
Yes, scars may occur at both surgical and donor sites. Most scars fade gradually over time.
Can I eat normally after surgery?
Many patients return to normal or near-normal eating after recovery and therapy.
Speak to a cancer care specialist
Get an expert opinion and a personalised treatment plan at Sterling Hospitals.
