Head and Neck Recipient Vessels Access

Since the dawn of microsurgical techniques and the standardisation of reconstructive principles for head and neck reconstruction, recipient vessels selection is crucial for successful free tissue transfers. The size, function, anatomical region of the defect, along with the concurrence of neck lymph nodes dissection or other patient factors (such as previous surgery or radiotherapy) make head and neck microsurgery challenging, especially in a vessel depleted neck. Economy and preservation of recipients in primary surgeries and creative solutions for extreme circumstances in cases with multiple previous surgeries and radiotherapy along with careful planning that allows multiple alternative back-up choices are critical. Herein, a detailed description of available arterial and venous recipients for head and neck reconstruction is presented and a step-by-step guide is demonstrated for the commonest vessels used, the facial artery.