Reconstructive Surgery

Cancer surgery and sometimes surgery for non-cancerous lesions of the head and neck can result in defects of skin, facial structures, internal lining of the mouth and throat, soft tissue and bone. These can range from minor to complex. Reconstructive surgery, including microvascular free tissue transfer, is a type of advanced surgery Dr Wykes uses to help return the head, face and neck to as close to normal function and appearance as possible for complex defects.

Preparing for reconstructive surgery

Surgical treatment for head and neck cancer can have significant and debilitating impacts on a person’s life. Having surgery to remove cancer or lesions can leave a person unable to speak, swallow, hear or see or with considerable facial disfigurements. Everyday life skills like eating, breathing, drinking, talking and swallowing can also be disrupted. There will also be space where the cancer or lesion used to be that requires reconstruction using highly specialised surgery. 

Dr Wykes will extensively plan your treatment alongside other specialists, including other head and neck surgeons, microvascular reconstructive surgeons and prosthodontic specialists. If your surgery is part of treatment for cancer, you will also be cared for by many members of the cancer care team, who will help you learn how to live well through radiation therapy, recovery and long-term care.

About microvascular free tissue transfer

Microvascular free tissue transfer is a surgical technique for rebuilding the face and neck using bone, muscle, skin and nerves from other parts of the body along with their native blood supply. It is specialised, major surgery using the most advanced surgical techniques available to treat head and neck cancers.

Due to the complex nature of these defects, tissue is transferred from another part of the body and is transplanted into the head and neck and is given its own blood supply by joining the tiny vessels that supply it to vessels in the neck with microsurgery.

Microvascular free tissue transfer is often used in advanced cancer treatment to replace skin, jaw, tongue, and the lining of the mouth. It is often accompanied by some combination of radiotherapy, chemotherapy and more recently immunotherapy, as well as extensive dietician support, rehabilitation and physiotherapy.


What does reconstructive surgery involve?

Microvascular free tissue transfer is performed after extensive testing, planning and consultation by multidisciplinary care teams. This type of advanced reconstructive surgery often involves several surgeons working alongside each other. Dr Wykes will prepare a comprehensive surgical plan with any other surgeons involved in the operation. Given the complexity and difficulty of these procedures, there are risks and potential side effects to be aware of that Dr Wykes will discuss with you prior to surgery. Depending on your condition, the surgery may involve:  

  • Multiple surgeons across 8 - 12 hours of surgery

  • Use of virtual planning tools to prepare for and guide each stage of surgery

  • Harvesting flaps of healthy tissue from another part of your body (eg from your arm, thigh, leg, hip, back or other site) with its blood supply

  • Transferring the tissue to the affected area of the head and neck

  • Using a microscope to attach the blood vessels of the flap to blood vessels in the head or neck, allowing the tissue to live as if it were back in its original location

  • Placing a temporary breathing tube (tracheotomy) and/or feeding tube (nasogastric or orogastric) to help you breathe and eat while your wounds heal

  • Monitoring your ongoing recovery for 1-2 days in intensive care, followed by 7-10 days in hospital

  • Extensive would care and rehabilitation either in hospital or in out-patient clinics

Where will I have my surgery?

This major surgery is performed by Dr Wykes alongside specialised surgical teams at the Chris O’Brien Lifehouse, The Wollongong Hospital or Wollongong Private Hospital. 

What is the recovery like after reconstructive surgery?

Reconstructive surgery has many side effects that range from short term discomfort post-surgery to lasting impacts as a result of significant changes to the important structures in your head, neck or face.

Dr Wykes will discuss the risks and potential side effects of surgery with you and make a plan for how to manage them. This may include planning to have future additional surgeries or cosmetic procedures after your initial operation when the results from any follow up treatment (eg radiotherapy or immunotherapy) are confirmed.