CPMC Microvascular Surgery

Microsurgery surgery is a type of surgery performed under the magnification of a microscope. The blood vessels and nerves that supply fingers and small body parts such as ears, scalps, tongues and noses are so small that surgeons need to use a microscope to place sutures in blood vessel walls and nerve coverings. This process establishes or re-establishes connections for blood flow and nerve transmission.

Since 1970, California Pacific Medical Center’s Microsurgery Service at the Davies Campus has performed thousands of successful reconstructive procedures, giving new hope to patients. We performed the first human toe-to-hand transplant in 1972, and in 1976 achieved the first scalp replant and the first four-digit replant in the United States.

Microsurgery services include:

• Emergency Replantation Surgery — In these procedures, the immediate survival of the part depends on the reattachment of the blood vessels. But the ultimate goal is to restore function, so it’s also crucial to repair bone, nerves, tendons and soft tissue. For severe damage, some patients may require follow-up reconstructive work.
• Microvascular Transplants — These are elective reconstruction operations, such as for defects created by trauma or cancer resection. Surgeons can transplant lower abdominal tissue to the chest to create a breast after mastectomy; a great toe to make a new thumb after thumb amputation; or, in a female-to-male gender affirmation operation, forearm tissue to the position of a phallus.
• Nerve Repair and Nerve Grafting — During a nerve repair procedure, two ends of a nerve are sewn together to help the nerves regenerate. If there’s extensive damage to a nerve and the two ends can’t be connected, a nerve graft is used to bridge the gap.

We specialize in reconstructive operations such as:

• Toe-to-Hand Transplant — Surgery that reconstructs a thumb or finger(s) with a great toe or second toe transplant.
• Facial Paralysis Re-animation — Surgery to restore natural and balanced movement in facial nerves damaged by trauma or disease.
• Limb Salvage — Surgery to replace damaged or missing bone and soft tissue to prevent amputations.
• Tissue Replant — Replantation of amputated parts such as fingers, hands, arms, feet, ears, lips, tongue and scalp.
• Microsurgical Breast Reconstruction — Uses lower abdominal (tummy tuck) tissue or inner thigh tissue for breast reconstruction.
• Complex Microsurgical Hand and Upper Extremity Reconstruction