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Reconstructive Procedures

Reconstructive Procedures

MICROSURGERY

MICROSURGERY

Microsurgery is a reconstructive procedure that repairs the patient's blood vessels and nerves. This is a highly specialized field in plastic surgery and consists of procedures used to resolve complicated reconstructive issues when grafting, primary closure or local flap transfer are not sufficient.

It involves the transplant of tissues from one area of the body to another for the functional and aesthetic restoration of defects caused by trauma, cancer or congenital conditions.

Microsurgical procedures are undertaken within a multi-disciplinary team which may include medical, radiation and surgical oncologists, pathologists, intensive care physicians, maxillo-facial surgeons, prosthodontists, dieticians, physiotherapists and psychologists.

Procedure

Standard microsurgery procedures include:

  • Breast reconstruction surgery:
    After the patient’s mastectomy, she will require breast reconstruction surgery through a tissue transfer (flap). For breast reconstruction, the surgeon transfers skin and fat from a donor site to reconstruct the patient’s breasts. If there is excess tissue of the lower abdomen, this may be used as the donor site consequently creating a tighter flatter tummy, which may be viewed as a benefit.
  • Head and neck reconstructive surgery:
    Head and neck reconstructive surgery through a tissue transfer involves restoring the patient's head or neck through the use of muscle, skin, fat, blood vessels or bone from another part of the patient's body. Areas of the head and neck that may require reconstruction include the tongue, lips, floor of mouth, mandible, maxilla and face.
  • Head and neck reconstructive surgery:
    Head and neck reconstructive surgery through a tissue transfer involves restoring the patient's head or neck through the use of muscle, skin, fat, blood vessels or bone from another part of the patient's body. Areas of the head and neck that may require reconstruction include the tongue, lips, floor of mouth, mandible, maxilla and face.
  • Nerve repair or grafting:
    Nerve repair entails connecting both ends of a severed or damaged nerve, but if the gap between both cut ends of the nerve is too large, the surgeon takes a portion of an expendable nerve from another region of the body to close this gap. This is usually necessary in traumatic injury of the nerves of the upper or lower limbs.
  • Bone reconstruction:
    After the resection of bone cancer, especially of the limbs, a free fibula (bone) flap may be harvested from the lower leg, to reconstruct the defect.
  • Soft tissue reconstruction:
    Large defects created by soft tissue cancers may need to be reconstructed with flaps (tissue) transferred from the thighs or other donor sites.
  • Lymphoedema surgery:
    The treatment of lymphoedema with highly specialized techniques which include free vascularized lymph node transfers and lymphatico-venous anastamoses.

The duration of the microsurgical procedure depends on each case. Generally, microsurgery takes four to twelve hours.


General anaesthesia.


Inpatient procedure.


Side effects include bleeding, swelling, infection, scarring, skin loss, seroma, skin discolouration and pain.


The major risk of microsurgery involves complications due to the extent and complexity of the procedure, including deep vein thrombosis and pulmonary embolism and tissue transfer necrosis due to failure of revascularization of the vessels.


Recovery is usually prolonged and a patient may need hospitalization for up to 10 days in hospital depending on the complexity of the surgery.


Typically, after microsurgery, the patient experiences swelling, which will eventually subside over time. Results may only be noticeable a few months after the procedure. Subsequent smaller procedures may be required to improved or enhance the results of the initial microsurgical reconstruction.


WHEN YOU CHOOSE A DOCTOR WHO IS A MEMBER OF APRASSA, YOU CAN BE ASSURED THAT YOUR SURGEON IS QUALIFIED IN ALL ASPECTS OF COSMETIC AND RECONSTRUCTIVE SURGERY.

Find a Surgeon

The Association of Plastic, Reconstructive and Aesthetic Surgeons of Southern Africa was formed in 1956. It currently has over 169 members from all around South Africa. All our members are fully qualified Plastic surgeons that have been approved for APRASSA membership and will endeavour to provide you with excellent care throughout your plastic surgery journey.









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