Microvascular Free Flap Surgery for Head & Neck Cancer Reconstruction
Radical oncological resection of advanced oral cancers (tongue, jawbone, buccal mucosa, palate) leaves composite structural defects that cannot be closed primarily or with local tissues. Without immediate advanced reconstruction, patients face devastating impairments in speech, swallowing, airway security, and facial form. Microvascular free tissue transfer (free flap surgery) represents the worldwide pinnacle of reconstructive plastic surgery, restoring form, function, and dignity.
Workhorse Free Flaps in Head and Neck Reconstruction
Dr. Vishal Purohit selects and customizes free flaps based on the specific anatomical tissues lost:
- Free Fibula Osteocutaneous Flap: The gold standard for jawbone reconstruction. A segment of vascularized leg fibula bone is harvested, osteotomized to recreate the mandibular arch, and plumbed into neck blood vessels to support future dental implants.
- Anterolateral Thigh (ALT) Flap: A versatile, high-volume soft-tissue flap from the thigh, ideal for tongue reconstruction, cheek through-and-through defects, and total maxillectomy cavities.
- Radial Forearm Free Flap: A thin, pliable fasciocutaneous flap ideal for reconstructing floor-of-mouth, soft palate, and mobile tongue defects requiring intricate mobility.
Microvascular Anastomosis and Functional Rehabilitation
Under 10x to 25x surgical microscope magnification, 1 to 2 mm arteries and veins are reconnected with 9-0 and 10-0 nylon sutures to establish immediate blood circulation. Comprehensive postoperative speech and swallowing therapy helps patients return to normal oral eating and social life.





