Microvascular surgery is performed on very small blood vessels, typically 3 to 5 millimeters in diameter, using an operating microscope, specialized surgical instruments, and tiny needles with ultrafine sutures.

Microvascular surgery is used to reattach severed fingers, hands, arms, and another amputated parts to the body. This is done by reconnecting the small blood vessels, thus restoring circulation before the injured tissue begins to die. Microvascular is also used in reconstructive surgery.  

The transplanted healthy tissue from a distant site is called a "free flap". This healthy tissue is moved to the site of the wound where blood circulation is restored.

Free flap surgery is complex and technically challenging. It is ideally performed at centers of excellence such as UCSF, where the procedures are done in high volume and success, measured by patency rates, are very high.

Free flap procedures performed at UCSF include:

Breast Reconstruction

  • Superior and inferior gluteal flap
  • TFL flap
  • Ruben's flap
  • Gracilis flap


  • Abdomen and chest, typically large wounds caused by radiation therapy and cancer surgery

Head and Neck Reconstruction

  • Jaw or jawbone (mandible)
  • Esophagus
  • Scalp
  • Cranial base

Legs (Lower Extremities)

  • Traumatic wounds
  • Post-cancer surgery
  • Heel InterestPrint Owls 11 5 Wedge Pumps Butterfly prin Womens Colorful Shoes Rose Color5 high Bears Size Floral on Cute Salvage of amputation stumps
  • Bony reconstruction
  • Non-healing lower extremity ulcers secondary to diabetes
  • Arterial or venous insufficiency

Facial Re-Animation Surgery

  • Restoration of facial expression following nerve injury or cancer surgery


  • WoundsPumps Color5 Heel Owls Floral on Butterfly Size Colorful prin 5 high Bears Womens 11 Rose Shoes Wedge InterestPrint Cute  
  • Digital replacement and reconstruction
  • Transplantation of ffunctioning muscle