Introducion: Head and neck reconstructive surgery comprises free vascularized tissue transfer which became a gold standard. The aim of reconstructive surgery is not only to cover various types of defects but also to restore the harmony and function as much as possible. This is not an easy task and very often in oncology we deal with the medically compromised patients, so the overall success in microvascular reconstruction vary in between 85 and 96%.

Aim: The aim of this study is to present the results of extensive facial skin defect microsurgical reconstructions and give a critical review.

Materials and methods: In the last five years we performed more than 54 major reconstructions in the head and neck, using variety of microvascular flaps.

Results: Overall success was 88%. Some of the patients had very specific case histories and complications such as a late ischemic necrosis (3) occurred when we have not expected it.

Conclusion: In conclusion we can say that careful choice of patients for microsurgical reconstruction is very important in order to obtain positive results, but we often have to count patients condition and habits as a conscious risk in order to attempt more and give them a better chance for quality life.

Conflict of interest : None declared.