Scapular Free Flap

Why would you need this surgery?

A scapula free flap uses your own healthy tissue to rebuild an area of your body damaged by cancer, injury, or another condition. Skin, soft tissue, and a section of bone from the shoulder blade area can be carefully transferred along with its blood vessels to rebuild areas such as the jaw, mouth, or face. Because the tissue comes from your own body, it can become a living part of the reconstruction.

Swipe through the images below to see how it works!

What happens after surgery?

It’s important to note that every patient’s recovery is different. Your surgical team will give you instructions based on your specific procedure and needs.

1. Watching the Flap Closely

During the first few days after surgery, your care team will monitor the flap closely to make sure blood is flowing properly. They may check its color, warmth, and blood flow using specialized monitoring techniques.

2. Caring for Both Surgical Areas

After a scapular free flap, your body is healing in two main places: the area being reconstructed and the upper back or shoulder area where the tissue was taken. Your care team will monitor both areas and provide instructions for dressings, pain control, and wound care.

3. Gradually Returning to Movement

Movement and activity are usually reintroduced gradually. Your care team may help you safely sit, stand, walk, and regain strength. Because the donor tissue comes from the shoulder blade area, you may have some discomfort or stiffness around your shoulder and upper back while the area heals.

4. Continuing Your Recovery

Recovery continues after you leave the hospital. Follow-up visits allow your surgical team to monitor healing and answer questions along the way. Over time, swelling and discomfort improve, incisions heal, and your body continues adjusting to the reconstruction.

Quick Facts:

How long is surgery?
Scapular free flap surgery often takes about 8–12 hours, depending on the type and complexity of the reconstruction. In a large multicenter study of head and neck bone free flaps, scapular flaps had a median operative time of about 11.5 hours. 

• How long will I stay in the hospital?
  Many patients stay in the hospital for about 1–2 weeks, although the length of stay depends on the reconstruction and individual recovery. One large multicenter study found a median stay of 10 days for scapular flaps. 

• Where does the tissue come from?
  The flap comes from the upper back and shoulder blade area. Depending on what is needed, it can include skin, soft tissue, and/or a section of the scapula (shoulder blade). 

• Can the flap include bone?
  Yes. A section of the scapula can be included when bone is needed for reconstruction, such as for certain jaw or facial bone defects. The flap can also be designed to include different types of soft tissue. 

• Are the blood vessels reconnected?
  Yes. The flap's blood vessels are carefully connected to blood vessels at the reconstruction site using microsurgery. This restores blood flow to the transferred tissue. 

• Will my shoulder still work normally?
  The shoulder and upper back need time to heal after surgery, and some patients can experience shoulder stiffness or reduced mobility during recovery. Activity and shoulder movement are gradually increased according to your surgical team's instructions. 

• Will I have a scar?
  Yes. You will have a scar on the upper back/shoulder area where the flap was taken, as well as scars at the reconstruction site. The appearance of the scar depends on the size and type of flap used.