Flap Surgery


Search

Breast Reconstruction

Tissue Expansion

After Skin Cancer

After Head or Neck Cancer

Flap Surgery

Trunk and Lower Extremity

Member - American Society of Plastic Surgeons

Flap Surgery

Flap Surgery
Are You A Good Candidate
Meeting With The Doctor
How The Procedure Is Performed
What To Expect After Surgery
Possible Side Effects And Risks
How Long Will The Results Last
Questions You May Have

Flap Surgery
The term flap refers to a section of living tissue that carries its own blood supply and is moved from one area of the body to another. Though success largely depends on the extent of injury, flap surgery has greatly improved a surgeon's ability to help a severely injured or disfigured patient. Using advanced techniques that may take hours to perform and that may require the use of an operating microscope, plastic surgeons can transplant large sections of tissue, muscle, or bone from one area of the body to another with the original blood supply intact. The surgeons at The Metropolitan Institute for Plastic Surgery have successfully used flap surgery to restore form and function to areas of the body that have lost skin, fat, muscle movement, and/or skeletal support.

Are You A Good Candidate for Flap Surgery?
If you have been severely injured in an accident or have genetic disfigurement or defects from surgery that have caused the loss of skin, fat, muscle, and or skeletal support, you may be a good candidate for flap surgery. Though every patient and every surgery is unique, flap surgery is often used in cases where skin grafts are unsuitable or when the injury or disfigurement is extensive.

Meeting With The Doctor
In a surgery as unique and complex as flap surgery, the communication and understanding between you and your doctor are essential to a successful surgical outcome. For this reason, you will meet at length with the doctors and staff of The Metropolitan Institute for Plastic Surgery while you are planning your surgery. The doctor will examine and evaluate your injury or disfigurement and will explain in detail the possible surgical options and their results. The goal is to ensure that you understand and feel comfortable with the procedure and its potential risks and expected results.

During your initial consultation, the doctors and staff at The Metropolitan Institute for Plastic Surgery will:

� Clearly discuss the potential risks of the procedure
� Explain which type of anesthesia will be used, where the surgery will be performed, and how long a hospital stay is required
� Outline in detail how the surgery is performed and what you can expect before, during, and after the procedure
� Provide detailed cost, payment, and insurance information
� Answer all your questions

You will be asked to provide:
� Details about your medical history
� A list of all medications you currently take including over the counter medications such as aspirin, vitamins, and herbal supplements
� Information regarding your tobacco and alcohol consumption.

How The Procedure Is Performed
Depending on the extent of your surgery, it will either be performed at one of the region's premiere accredited outpatient-based surgical facilities: the Center for Ambulatory Surgery, Inc. (CASI) or the Washington Hospital Center, or at one of the area hospitals if an overnight stay is required. The complexity of your surgery also determines which type of anesthesia will be used. Both where your surgery will be performed and the type of anesthesia to be used will be discussed with you during your initial consultation.

The basic concept behind flap surgery is that the doctor surgically removes tissue from one part of the body and moves it to the area to be repaired. If microsurgical free tissue transfer is needed, the original blood vessels in the tissue are reconnected to the existing blood vessels located in the area to be repaired. Several types of flap surgery can be performed:

� In local flap surgery, a piece of skin and underlying tissue that lie adjacent to the wound are used. The flap remains attached at one end so that it continues to be nourished by its original blood supply, but it is repositioned over the surgical area.

� A regional flap uses a section of tissue that is attached by a specific blood vessel. When the flap is lifted, it needs to retain only a very narrow attachment to the original site to receive its nourishing blood supply from the tethered artery and vein.

� A muscle and skin flap is used when the area to be covered needs more bulk and a more robust blood supply. These types of flaps are often used to rebuild a breast after mastectomy. With muscle and flap surgery, the flap remains tethered to the original blood supply.

� With a bone/tissue flap, bone along with the overlying skin is transferred to the surgical area, carrying its own blood supply.

� A microvascular free flap is a section of tissue that is completely detached from its original site and reattached to its new site by reconnecting all its blood vessels to new blood vessels in the surgical area.

What To Expect After Your Surgery
Due to the range of possibilities that exist with flap surgery, a strict timeline of expected recovery goals cannot be generalized. During your consultation, the doctors and staff will discuss your recovery process in detail.

Immediately After Your Surgery
With most types of flap surgery, a hospital stay is required. The number of nights in the hospital depends on the type and extent of your surgery. In most cases, you will experience mild to moderate discomfort immediately following surgery. Pain medication will be prescribed to alleviate as much post-surgery pain as possible. You will also have some bruising, swelling, and numbness in the area of your surgery. It is wise to have someone drive you home when you are released from the hospital and to have someone stay with you for a few days after you return home.

The First 24 to 48 Hours After Your Surgery
During the first 24 to 48 hours after your procedure, you will feel tired from the anesthesia and sore from the surgery. The doctor will prescribe pain medication to alleviate much of the discomfort. Your discomfort level will improve rapidly after the first two days.

You may experience some minor bleeding or oozing in the area of your incision. This bleeding or oozing usually results in a slight staining of the gauze dressing placed over the surgical area. If more than a slight staining of the gauze occurs, call the staff at The Metropolitan Institute for Plastic Surgery.

In most cases, movement of the surgical area will be limited and your normal activity level will be restricted for some time after surgery. Specific details about your recovery from surgery will be provided during your initial consultation.

The First Two Weeks After Surgery
You will notice a marked improvement in your discomfort and activity level during the first few weeks after your surgery. You should be able to return to work during this time and will, in most cases, have your stitches removed. In addition, any bruising you experience will usually disappear in about two weeks. The doctor will most likely prescribe a regimen of physical therapy to help you regain function in the area affected by the surgery. The specific details regarding your physical therapy, as well as instructions on your recovery from surgery, will be provided during your initial consultation.

Resuming Your Normal Routine
Everyone heals at different rates and you are the best judge of when you are ready for certain activities, but the following are general guidelines:

� You can most likely return to work about a week from the date of your surgery, unless your work is strenuous.
� Strenuous exercise can begin in about three to six weeks after surgery; the doctor will give you specific instructions on when to return to your exercise program.
� The scars from your surgery should be protected from sunlight for at least a year after surgery.
� Most scarswill fade substantially over time; though it may take one or two years for them to become much less visible.

What Are The Possible Side Effects or Risks?
Like all surgical procedures, there are risks associated with flap surgery. During your pre-surgery consultation with your doctor, your individual risks will be assessed and discussed in detail. As with any surgery, you can help reduce the risks associated with your surgery by closely following the instructions provided to you by the staff of The Metropolitan Institute for Plastic Surgery. And, the doctors and staff at the Institute will be with you every step of the way to ensure a safe and pleasing outcome.

Possible side effects include:
� Infection
� Fluid collection
� Reduced mobility
� Scarring
� Hematoma
� Delayed wound healing
� Flap loss

How Long Will the Results of Your Flap Surgery Last?
In most cases, flap surgery can restore mobility, comfort, and normal appearance to areas injured by trauma or disfigured by disease. The results of your flap surgery are permanent.

Questions You May Have
� Will my insurance coverage pay for my flap surgery?
Generally, flap surgery is covered by insurance. The staff at The Metropolitan Institute for Plastic Surgery will work with you to obtain pre-approval from your insurance company.

� Are there alternatives to flap surgery?
In cases where the wound or disfigurement does not require extensive tissue or muscle, skin grafting may be suitable to correct the injury or disfigurement. During your initial consultation, the doctor will go over any possible alternatives or options with you.