Microsurgical free flap reconstruction moves living tissue, such as skin, muscle, bone or fat with its own artery and vein, to another body area and joins its vessels to local ones under a microscope. It is used to rebuild large defects caused by tumours, burns, injuries or earlier surgery when simpler methods are not enough, and the treating team decides if it is appropriate.
It is performed under general anaesthesia. The team selects a flap by the size and site of the defect, for example from the thigh, forearm, back, abdomen or fibula. The tissue is lifted with its vessels, arteries and veins are joined with very fine stitches under the microscope, the flap is secured, the donor site is closed, and drains are placed.
Surgery often lasts six to twelve hours, with a hospital stay of several days and close monitoring of the flap's blood supply, sometimes in intensive care. Recovery takes weeks to months with physiotherapy, and refinements may be needed. The final result usually becomes clear after six to twelve months, varying from patient to patient.
The final cost is set after a medical consultant reviews your case and photos.
Bilgehan İlker completed his medical education at Trakya University Faculty of Medicine and specialized in Plastic, Reconstructive, and Aesthetic Surgery at Dokuz Eylül University. He has performed hundreds of aesthetic and reconstructive procedures and has participated in academic research projects supported by TÜBİTAK. Dr. İlker is also an active member of national and international plastic surgery societies.
Op. Dr. Ali Can Günenc is a physician specializing in Plastic, Reconstructive, and Aesthetic Surgery. He completed his medical education between 2007 and 2013 at the Istanbul University Istanbul Faculty of Medicine. He then completed his residency at the University of Health Sciences Şişli Etfal Training and Research Hospital between 2013 and 2019, earning his title as a specialist. After advancing his professional career at Şişli Etfal and Yalova State Hospital, he currently provides services to his patients at the Medical Park Florya hospital. Dr. Günenc holds the European Board Certificate ...
Asst. Prof. Dr. Emrah Köksal is a plastic, reconstructive and aesthetic surgeon at Medical Park Göztepe Hospital (since 2025). He graduated from Trakya University Faculty of Medicine (2017) and completed his specialty training at Gülhane Military Medical Academy (2017-2023), then worked at Hakkari Yüksekova State Hospital. His focus includes closed rhinoplasty, breast aesthetics, eyelid surgery, face and neck lift, liposuction and BBL, and body contouring lifts.
Prof. Dr. Halil İbrahim Canter is a plastic, reconstructive and aesthetic surgeon at Liv Hospital Vadistanbul (since 2022). A Hacettepe University graduate, he completed residency and a PhD in plastic surgery there, plus a craniofacial surgery fellowship at Providence Hospital, Michigan (USA). His interests include breast and facial aesthetic surgery, craniomaxillofacial surgery, hand surgery and cleft lip and palate repair.
Assoc. Prof. Dr. Erdem Güven is a plastic, reconstructive and aesthetic surgeon at Acıbadem Maslak Hospital, with the Acıbadem Healthcare Group since 2019. He graduated from Istanbul University Istanbul Faculty of Medicine (1998), qualified there in plastic surgery (2004), and holds subspecialty certification in hand surgery (2011) and oral and maxillofacial surgery (2012). His interests include breast augmentation and reduction, facelift, mommy makeover and Mohs reconstruction.
Prof. Dr. Naci Karacaoğlan is a plastic and reconstructive surgeon at Medipol Mega University Hospital and head of plastic, reconstructive and aesthetic surgery at Istanbul Medipol University. A 1984 Erciyes University graduate, he specialised in 1991, taught at Ondokuz Mayıs University, became associate professor in 1997 and joined Medipol in 2003, later serving as chief physician and medical faculty dean (2010-2025). He has published widely on flap and burn reconstruction.
Prof. Dr. Necmettin Kutlu is a plastic, reconstructive and aesthetic surgeon at Medicana International Istanbul (Beylikdüzü). He graduated from Istanbul University Faculty of Medicine in 1982 and specialised in plastic surgery at Ankara University in 1991, later working at Karadeniz Technical University and Okmeydanı Training and Research Hospital. His interests are aesthetic and reconstructive surgery, hand surgery and maxillofacial surgery, with publications on flaps and microsurgery.
Dr. Salih Cem Altunal is a plastic, reconstructive and aesthetic surgeon at BHT Clinic Istanbul Tema Hospital. He graduated from Istanbul University Cerrahpaşa Faculty of Medicine and completed his specialty training at Istanbul Kartal Dr. Lütfi Kırdar City Hospital. He has since worked at Mersin City Hospital, Kartal City Hospital and Prof. Dr. Cemil Taşçıoğlu City Hospital. His practice covers rhinoplasty, tummy tuck, breast surgery, BBL, liposuction, face and neck lifts and eyelid surgery.
Prof. Dr. Yakup Çil is a plastic, reconstructive and aesthetic surgeon at Istanbul Aydın University VM Medical Park Florya Hospital. A 1997 graduate of Gülhane Military Medical Academy (GATA), he completed his plastic surgery residency there in 2005 and became an associate professor in 2015. He has led plastic surgery clinics at military and city hospitals in Eskişehir, Diyarbakır and Ankara, and focuses on facial and nasal surgery, breast aesthetics, microsurgery and reconstruction.
Assoc. Prof. Dr. Mehmet Emre Yeğin is a plastic, reconstructive and aesthetic surgeon at Liv Hospital Bahçeşehir and Liv Hospital Ulus. He studied medicine at Akdeniz University and completed his residency at Ege University's plastic surgery department, then worked in the plastic surgery and burn units of Ege University Hospital and Elazığ hospitals. His work covers aesthetic surgery, microsurgery, breast and head-and-neck reconstruction, lymphedema surgery and post-bariatric body contouring.
Assoc. Prof. Dr. Burak Özkan is a plastic, reconstructive and aesthetic surgeon at Medipol Mega University Hospital and Medipol Acıbadem Regional Hospital. A 2009 graduate of Ege University, he completed plastic surgery training at Başkent University (2015) and worked there as a faculty member until 2024. He performs breast, face, eyelid and body contouring surgery, as well as post-cancer breast reconstruction, microsurgery and skin cancer surgery.
Prof. Dr. Şükrü Yazar is a plastic, reconstructive and aesthetic surgeon at Acibadem Altunizade Hospital, with Acibadem since 2005 and professor at Acibadem University since 2013. Trained at Istanbul University Cerrahpaşa, he gained reconstructive microsurgery experience in Cambridge, Glasgow and at Chang Gung Memorial Hospital in Taiwan. He holds the European Board in plastic surgery and board certifications in hand and maxillofacial surgery.
Prof. Dr. Cihangir Tetik is a hand surgeon and microsurgeon at Acibadem Maslak Hospital, with Acibadem since 2007. A 1984 graduate of Ondokuz Mayıs University, he trained in orthopedics in Ankara, in hand surgery and microsurgery at the University of Utah, and in microsurgery research at Cleveland Clinic. Professor at Marmara University from 2005, he founded its hand surgery and microsurgery unit, and treats hand, wrist, nerve and tendon injuries and pediatric hand anomalies.
Prof. Dr. Hakan Ağır is a plastic, reconstructive and aesthetic surgeon and maxillofacial surgeon at Acibadem Altunizade Hospital, with Acibadem since 2020. A 1991 Hacettepe University graduate, he trained at Istanbul University and completed craniofacial fellowships in Adelaide, Wellington and at Chang Gung in Taiwan. Professor at Kocaeli University from 2015, he holds the European Board (FEBOPRAS) and treats cleft lip and palate, facial anomalies, rhinoplasty and breast surgery.
Op. Dr. M. Baver Acaban is a plastic, reconstructive and aesthetic surgeon at Medical Park Pendik and Maltepe. He graduated from Istanbul University Cerrahpaşa Faculty of Medicine in 2012 and completed plastic surgery training at Mersin University (2015-2020). He worked at Tarsus State Hospital, Mersin City Hospital and Acıbadem Taksim and Fulya hospitals, co-translated the Turkish edition of Kevin Chung's 'Flaps in Plastic and Reconstructive Surgery' and has published on free flaps and hand reconstruction. He performs blepharoplasty, rhinoplasty, facelift, breast, liposuction, tummy tuck and ...
Op. Dr. Hüsrev Purisa is a hand and microsurgery specialist at Liv Hospital Bahçeşehir. He graduated from Istanbul University Faculty of Medicine and completed his specialty training in plastic and reconstructive surgery at Istanbul University. He worked at İren Hospital from 1998 to 2000 and at Tem Hospital from 2000 to 2018. His practice covers hand and finger injuries, chronic and autoimmune hand disorders, and nail deformities.
Opr. Dr. Ahmet Aydın is a specialist in Plastic, Reconstructive, and Aesthetic Surgery based in Istanbul. He graduated from Cerrahpaşa Medical Faculty and completed his specialty training at Erciyes University. He received microvascular surgery training in Taiwan and has worked at Hakkari State Hospital and Medipol Mega University Hospital. He currently sees patients at his private clinic.
Dr. Nargiz Ibrahimli is a specialist in plastic, reconstructive and aesthetic surgery at Acıbadem Kent Hospital in İzmir. She graduated from Azerbaijan Medical University Faculty of Medicine in 2017 and completed her specialty training in plastic, reconstructive and aesthetic surgery at Ege University Faculty of Medicine in 2024. She joined the Acıbadem Healthcare Group in October 2024 and has 8 years of medical experience.
Prof. Dr. A. Özlem Gündeşlioğlu is a plastic, reconstructive and aesthetic surgeon at Medicana International Izmir Hospital. A 1993 Ankara University graduate, she specialised at Ankara Dışkapı Training and Research Hospital in 2002 and trained in the Department of Plastic and Reconstructive Surgery at MD Anderson Cancer Center in Texas. Formerly at Necmettin Erbakan University Meram, she performs head and neck and breast reconstruction, rhinoplasty, facial aesthetics and body contouring.
Prof. Dr. Dilek Demirez is a plastic, reconstructive and aesthetic surgeon at Medstar Antalya Hospital. She graduated from Ankara University Faculty of Medicine in 1994 and completed her plastic surgery residency there (1997-2002). She worked at Ankara Numune Training and Research Hospital, Abant İzzet Baysal University and Antalya Training and Research Hospital, then at Medical Park Antalya, before joining Medstar Antalya in 2022. She became associate professor in 2011 and professor in 2018. She performs rhinoplasty, eyelid surgery, tummy tuck, neck lift and gynecomastia surgery, and treats c...
Prof. Dr. Ümit Naci Karaçal is a plastic, reconstructive and aesthetic surgeon at Memorial Ankara Hospital, where he also works in the Breast Center. He graduated from Hacettepe University Faculty of Medicine in 1994 and trained in plastic surgery at Ankara Numune Training and Research Hospital (1994-1999), where he then served as chief resident. He was a faculty member in plastic surgery at Karadeniz Technical University in Trabzon for over two decades (2001-2023) and at İzmir Bakırçay University (2023-2024) before joining Memorial Ankara in 2024. He performs rhinoplasty, breast reduction and...
Dr. Adham Mansour is a specialist plastic surgeon at Dr. Sulaiman Al Habib Hospital, Dubai Healthcare City. He trained as a specialist in plastic surgery and laser in France and is director of the Syrian Center for Plastic Surgery and Laser in Damascus. He is a member of IPRAS and the International Society of Hair Restoration Surgery. His work covers laser liposuction and fat transfer, breast surgery, tummy tucks, facial rejuvenation, rhinoplasty and hair transplants.
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It may restore large defects with living tissue that has its own blood supply, improving function, appearance and wound healing, and protecting exposed bone, organs or implants.
Usually someone with a large or complex tissue defect that cannot be treated with grafts or local flaps, and who is healthy enough for a long operation. The surgical and medical team decides after a thorough assessment.
Blood tests, vessel imaging, and heart and anaesthetic assessments are arranged. Stopping smoking is essential, for a period set by the doctor, because it threatens flap survival. Prescribed medicines are never stopped or changed without the team's instruction.
The chosen tissue is lifted with its vessels, connected to local vessels under the microscope, secured in place, and the donor site is closed. The flap's blood supply is checked frequently afterwards.
It includes a hospital stay, movement restrictions in the early days, pain, swelling, wound care and flap monitoring, followed by physiotherapy. Duration varies with the flap and donor site.
The result improves gradually over months. A successful flap usually becomes a permanent part of the body, although it may later need revision, thinning or scar treatment.
They include blocked vessels and partial or total flap failure, bleeding, blood collections, infection, delayed healing, weakness or pain at the donor site, blood clots, and the risks of a long general anaesthetic. Some situations need emergency return to theatre or further surgery.
Yes. Scars remain at both the recipient and donor sites, and the flap's colour and texture may differ from the surrounding skin. Scars usually improve with time but do not disappear completely.
Travel is generally advised only once the flap is stable and monitoring has ended, often after several weeks, and the treating team confirms the timing for each patient.
Nearby tissue may be damaged or insufficient, so a healthy flap with a reliable blood supply is taken from elsewhere to cover the defect and replace what was lost. The surgeon explains why a particular donor site is chosen for each case.
