How has facial reconstructive surgery changed over the years with the use of free flaps, and what issues may be on the horizon due to its success and expanded use?
Free Flaps: Revolutionary and Evolutionary
Prior to the introduction of microvascular free tissue transfer in the 1960s and 1970s, reconstruction treatment of large facial defects caused by head and neck cancers or trauma relied on the use of regional pedicled flaps that often left patients with permanent cosmetic and functional defects. Microvascular free tissue transfer enabled physicians to rebuild large anatomical areas that were missing due to a tumor, trauma or congenital defect by using tissue from one part of the patient’s body for use in reconstructing the defect.
“Free flaps are basically a transplant of a patient’s own tissue from one part of the body to another part, and the reason they are called “free” is that the vessels are detached at the primary location and then moved to another spot,” said Dr. Alam. For example, if someone has lost a part of their jaw because of cancer, bone can be taken from the patient’s leg along with the blood vessels and blood supply and transferred to the jaw in a free fashion to rebuild the jaw.