All Cancer surgery that are performed over face or over the head & neck lead to defects that make appearance grotesque, Immediate reconstruction by plastic Surgery can restore the appearance and help provide a socially presentable appearance. Reconstruction of facial defects following Cancer surgery has been a challenge to plastic surgeons since the beginning of this century. Old-fashioned reconstructions were done in multiple stages and use to take several months to complete. Till recently Reconstructions were done using skin and muscle (most commonly Pectoralis, the chest muscle) from the fore head or from the chest wall. These are called pedicled flap reconstruction. Such reconstructions are staged and are far from acceptable, as they appear very bulky.

Reconstructive surgery and use of Free Flaps for reconstruction of defects is the recent advance in cancer reconstruction of face and other parts of the body. These are single stage reconstructions can be combined with surgery for cancer and are called primary reconstructions. These can be performed any time from 6 weeks to several years after cancer surgery and are called Secondary Reconstructions.

The basic concept is to reconstruct a defect in all the three dimensions and all the tissues. If bone is missing bone is transferred along with skin fat muscle etc. The total material required for reconstruction is taken from the body of the same person, Most commonly from the forearm or from the legs or trunk and then it is transferred to the face, to make it survive and function the blood supply has to be restarted and this requires the skills of microvascular surgery.

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