Reconstructive microsurgery refers to the transfer of tissue from one part of your body to another part of the body utilizing microsurgical knowledge and techniques to maintain and restore blood supply to the transplanted tissue. This often requires the use of the operative microscope to perform surgery on blood vessels and nerves that are sub-millimeter in diameter. It is currently one of the most advanced methods for the restoration of defects in the face and body.
The cornerstone of reconstructive microsurgery is flap surgery. A flap is tissue with its own blood supply that is taken from one part of your body to replace missing tissue in another part. Almost any type of tissue can be taken as a flap, including skin, fat, muscle, bone, and nerve, either in isolation, or in combination as a chimera flap. When a flap is used without having to cut off its blood supply, it is referred to as a locoregional or pedicled flap. When the flap has its blood supply first cut off at the donor site and subsequently restored at the defect site, this is known as free tissue transfer or free flap surgery. With modern microsurgical techniques, free flap success rates remain consistent at 97 to 98%
More recently, reconstructive microsurgery has given rise to the fields of perforator flap and supramicrosurgery. In the former, small perforating vessels to the skin are isolated and the tissue transferred to the defect site with minimal donor site morbidity. In the latter, vessels and lymphatics that measure 0.8mm or less in diameter are sutured together under a microscope to restore tissue viability and function, and is most noticeably used in surgery to treat lymphedema