Reconstructive Surgery

In the video below, Dr. Namou Kim discusses microvascular reconstructive surgery after head and neck surgery. Microvascular surgery has changed the treatment standard of head and neck cancer surgery. Thirty years ago, many cancers could not be removed because a method did not exist to put things back together in a meaningful way. Now we do. Microvascular surgery allows us to restore functional and cosmetic loss that results from head and neck cancer surgery. It has allowed the treatment of cancers that were previously considered hopeless.

Cancers originating in the head and neck region often require complex surgical removal of the tumor that can lead to massive anatomical defects. These defects not only impact a patient’s self-esteem, but they also typically severely alter the patient’s ability to swallow, speak and breathe. 

In the past, reconstructive options were limited, and below-optimal cosmetic and functional results were “expected” side-effects when surgically treating head and neck cancers. However, microvascular surgical reconstructive techniques (free flaps) are now widely accepted as the method of choice to reconstruct and rehabilitate head and neck cancer patients.

For example, surgically treating a patient with cancer of the tongue and jaw often means removing the entire tongue and jaw. Today, surgeons are able to reconstruct the tongue and jaw bone by transferring tissue from another part of the body (an autograft). Tissue may be taken from the fibula (leg bone), or the skin of the thigh or forearm to reconstruct both the jaw bone and tongue. These autografts have small vessels supplying blood and nutrients that reconnect to vessels in the neck. 

Microvascular reconstructive techniques have greatly improved the outcome of the cosmetic and functional (speaking, swallowing and breathing) of head and neck cancer patients. It has also allowed surgeons to operate on patients who previously were considered “inoperable," since most cancer defects can now be “puzzled” back together with free flaps.

As with any complex surgery, experience with the procedure contributes to a reduction in complications. Swedish head and neck cancer surgeons have tremendous experience in these reconstructive surgeries, and the success rate has been significantly above national average.