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Ali et al. Plast Aesthet Res 2021;8:35 Plastic and
DOI: 10.20517/2347-9264.2021.29
Aesthetic Research

Review Open Access

Technological advancements in head and neck free
tissue transfer reconstruction

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Syed Ahmed Ali , Akina Tamaki , Jason E. Thuener , Shawn Li , Nicole Fowler , Pierre Lavertu ,
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Theodoros N. Teknos , Rod P. Rezaee 1,2
1
Department of Otolaryngology - Head and Neck Surgery, Ear Nose and Throat Institute, University Hospitals Cleveland Medical
Center, Cleveland, OH 44106, USA.
2
Department of Otolaryngology - Head and Neck Surgery, Case Western Reserve University School of Medicine, Cleveland, OH
44106, USA.
Correspondence to: Dr. Rod P. Rezaee, Department of Otolaryngology - Head and Neck Surgery, Ear, Nose and Throat Institute,
Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, LKS
5045, Cleveland, OH 44106, USA. E-mail: Rod.Rezaee@UHhospitals.org
How to cite this article: Ali SA, Tamaki A, Thuener JE, Li S, Fowler N, Lavertu P, Teknos TN, Rezaee RP. Technological
advancements in head and neck free tissue transfer reconstruction. Plast Aesthet Res 2021;8:35.
https://dx.doi.org/10.20517/2347-9264.2021.29
Received: 27 Mar 2021 First Decision: 27 Apr 2021 Revised: 9 May 2021 Accepted: 25 May 2021 First online: 2 Jun 2021

Academic Editors: Mark K. Wax, Matthew Spector Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Free tissue transfer (FTT) is a cornerstone of head and neck reconstruction. Although rare, complications of FTT
surgery can be devastating, including failed flap harvest, wound breakdown, or flap loss ultimately. Thus, modern
microvascular surgeons bolster surgical and clinical expertise with a growing number of technological advances to
optimize patient care and outcomes. These technologies can be applied in the preoperative, intraoperative, and
postoperative period. Various preoperative imaging modalities can assist in selecting the optimal donor site and
advanced perforator planning. Intraoperatively, novel technologies can assist with microvascular anastomoses,
operative magnification and visualization, and assess free tissue perfusion. Postoperatively, routine clinical
assessment can be augmented by a variety of adjunctive monitoring techniques designed to assess tissue health,
arterial inflow and venous drainage. The overall ease and success of performing FTT can be improved by employing
novel technologies at every phase of the surgical process. This article will expand upon established and upcoming
technological advances and the existing literatures to support their use.

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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