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Microsurgery is complex reconstructive surgical procedure used to attach blood vessels and nerves from tissues transferred from a donor site to a reconstruction site elsewhere on the body.
About Microsurgery
Reconstructive Microsurgery
Microsurgery in reconstructive surgery procedures
Many reconstructive surgical procedures involve the transfer of flaps of fat, skin and occasionally muscle tissue from a healthy area of the body (donor site) to a body area that has been injured or requires rebuilding following due to birth defects or other surgical procedures.
Microsurgery allows tissue flaps to be completely removed from the nerve and blood supply at the donor site and reattached using complex surgical techniques so that transplanted tissues can survive and form to the transplant area as naturally occcuring tissue would.
Any reconstructive surgery procedure that involves restoring body shape, such as breast reconstruction after mastectomy, restoring function, such as in face muscles, or covering exposed vital surfaces, such as tendons, joints, bone and blood vessels, may use microsurgery. Hand surgery involving finger reimplantation or transfer may also incorporate microsurgery.
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Microsurgery In Free Flap Breast Reconstruction
Microsurgery uses for breast reconstruction
One of the most common procedures where microsurgery is needed is free flap breast reconstruction, including TRAM free flap reconstruction.
Whereas standard TRAM flap breast reconstruction does not utilize microsurgery and instead requires blood vessels and tissue nerves to be tunneled through the abdomen from the donor site to the breast reconstruction site, free flap breast reconstruction procedures use microsurgery to detach then reattach tissue support structures.
During the free flap procedure, the end of each vessel is washed and secured with clamps and then a piece of contrast material is placed behind the surgical site. Magnification is used to ensure the tiny vessels are visible, and then end-to-end or end-to-side vessel reattachment is done. The reattachment method used depends on the recipient vessel, orientation of the flap tissue and the match between the size of donor and recipient vessels.
Sutures are placed to connect flap vessels to the donor site vessels, the clamps are released and blood is allowed to flow before the flap is closed.
The complexity of microsurgery makes it imperative that you seek an extremely well-trained and experienced plastic and reconstructive surgeon for your flap procedure.
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Microsurgery Recovery
Healing after microsurgery
Because microsurgery is generally performed as an adjunct procedure during another reconstructive surgery, recovery depends largely on the nature of the other surgical techniques performed and the body area being reconstructed.
Your body will need rest after microsurgery, so most patients are advised to stay in bed for five days and will need to take a blood thinner during this time. Swelling will occur, but keeping the recipient site elevated will help reduce swelling.
Because body temperature is closely related to vascular function, it is important that during microsurgery recovery you keep your body warm. Smoking is also strictly prohibited, as are all smokeless tobacco products containing nicotine, and can seriously compromise your microsurgery results.
Blood transfusions may be recommended during your recovery period, and pain medication may be used to manage your discomfort.
Microsurgery is a very delicate procedure, and its success depends largely on you following all pre- and post-operative instructions. Keep all follow-up appointments at Tyler Plastic Surgery so that Dr. Motlagh can monitor your healing progress and results.
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