Microvascular Reconstructive Surgery

Defects of the face, neck and mouth are often created when removing tumors or as the result of severe facial injury. Proper reconstruction is vital to allow patients to maintain the highest quality of life and self-esteem. Dr. Williams is one of only a handful of Oral & Maxillofacial Surgeons in Texas performing microvascular reconstructive surgery, and one of only a few dozen Oral & Maxillofacial Surgeons in the Unites States trained in this state-of-the-art form of reconstruction.  After finishing his 6-year surgical residency, Dr. Williams completed an additional 2 years of fellowship training at the University of Michigan to learn this specialized surgery.  In 2017, Dr. Williams became the first Oral & Maxillofacial surgeon in Texas to obtain his CAQ (Certificate of Added Qualifications) in Head & Neck surgery from the American Board of Oral & Maxillofacial Surgery.  

Microvascular reconstructive surgery is one of the most advanced options in restoring facial form and function following the removal of facial and oral tumors. Tissues from the patient’s own body are transplanted into the facial defects to restore function and appearance. These transplants (known as “flaps”) can be in the form of skin, muscle, bone, or any combination. The flap is removed from the body along with blood vessels that supply nourishment to the flap. The blood vessels are reconnected to vessels around the facial defect under a microscope using sutures smaller than a human hair. Once blood flow is re-established, the transplanted tissue remains alive just as it did in its original location. Because the flap is completely freed from another part of the body, this technique is often referred to as “free flap surgery” or “free tissue transfer.” This technique has a 95% success rate, which is very favorable compared to other techniques. Please keep in mind that many cases are more appropriately reconstructed with alternative procedures.

When necessary for microvascular jaw reconstruction, Dr. Williams utilizes computer-guided virtual surgery to plan the reconstruction with increased precision and usually with reduced operating time. Using this advanced technology, Dr. Williams works closely with biomedical engineers on most cases to offer truly customized surgical solutions for each patient.

While not all patients are candidates to undergo this form of reconstruction, Dr. Williams also performs many other forms of facial reconstructive surgery. The optimal reconstructive technique is tailored to each patient and chosen based on the patient’s wishes, goals, and available options.

Jaw on Four

One of the most troubling aspects of tumor removal is that it often requires removal of teeth which are in close proximity of the tumor.  Traditional reconstructive techniques require multiple operations over 6-18 months before the patient is able to have their teeth replaced.  In select cases, Dr. Williams is able to remove the tumor, reconstruct the missing bone, place four (or more) dental implants, and add teeth all in a single surgery.  The patient wakes up with a new smile.  A minimum of four implants is usually needed to support the teeth of an entire jaw.  Not all patients are candidates for this procedure so please contact Dr. Williams for more information.