What Is a Microvascular Surgeon? Flap Reconstruction Explained

A microvascular surgeon is a surgeon trained to reconnect very small blood vessels — often less than a few millimetres across — using an operating microscope. This specialised skill underlies free flap reconstruction, one of the more advanced techniques within reconstructive plastic surgery.

What Microvascular Surgery Involves

When tissue is transferred as a free flap, its artery and vein must be reconnected to blood vessels at the recipient site under microscope magnification, with sutures far finer than human hair. The flap's survival depends entirely on this connection working — which is why close monitoring in the days immediately after surgery is such a critical part of care.

When This Level of Reconstruction Is Needed

• Complex wounds where local tissue isn't sufficient to cover the defect
• Reconstruction after tumour removal, particularly for larger defects
• Severe trauma involving significant tissue loss
• Cases where a simple skin graft would not survive on the wound bed

Training Behind the Specialty

Microvascular technique is typically developed through dedicated fellowship training and focused courses beyond general plastic surgery training, given how technically demanding and high-stakes this work is.

Learn more about candidacy on the flap reconstruction & microsurgery procedure page.