The limitations of skin grafts led to the development of Free Flap Surgery which allows the transplant of any combination of skin, fat, muscle, fascia, bone from one part of the body (donor site) to another (recipient site) in this case the mouth or head and neck. This means that your surgeons can reconstruct, for example, a complete new tongue and jaw.

This is only possible through preservation of the small arteries and veins supplying the area and joining them together (anastomosis) with vessels in the neck under an operating microscope. This highly technical and complex type of surgery is termed microvascular Surgery, and the team at London head and neck surgery are at the forefront of leading UK microvascular surgeons.

Whilst microvascular surgery has been around for a few years now, continued developments and refinements led by Alastair and Luke, include techniques of 3D-printing patients jaws to allow accurate positioning for subsequent dental implants and rehabilitation, and scarless reconstruction by joining reconstructions to tiny vessels inside the mouth.

A wide number of different reconstructive options now exist which can be reliably employed in head and neck reconstruction. The decision is always tailored to you as an individual and your team will take time to discuss this with you in depth.

Free flaps can unfortunately fail – this usually means that a problem has developed either with the artery or the vein, causing a problem with the blood supply to the flap. Patients will be monitored very closely after this surgery for any signs of problems. Sometimes the flap can be saved if a problem is detected early.

Luke and Alastair’s flap success rate is now over 96% for several hundred reconstructions including very complex cases post radiotherapy.