The Triangle of Unfavorable Outcomes After Microsurgical Head and Neck Reconstruction: Planning, Design, and Execution

Analysis of unfavorable results in microsurgical head and neck reconstruction beyond free flap survival is the goal of this article. Unfavorable outcome is the result of poor or inadequate planning, design, and execution. A triangular relationship between the 3 corners of a microsurgical reconstruction—plan, design, and execution—is suggested to govern the unfavorable outcome after a surviving free flap. This article shares the authors’ philosophy and strategies to avoid untoward outcomes. Cases studies and the authors’ surgery dynamics are provided to simplify the message.