Reduction of Free Flap

Dr Cotrufo is an exceptional plastic surgeon. His outstanding skills and expertise extend far beyond the specialism of cosmetic surgery, which is why I am now travelling from Scotland to his Harley Street Clinic, London, for treatment.

I first met him in 2016 when he worked as a Consultant in plastic surgery at Aberdeen Royal Infirmary (ARI). I was transferred to ARI by air ambulance following a very serious road traffic accident in which, as a pedestrian, I had become trapped between 2 cars. I sustained a severe crush injury to my right leg with massive circumferential soft tissue loss and open 3b proximal tibia and fibula fracture. The severity of my injury meant there was a considerable risk of amputation and presented both the Orthopaedic and Plastics teams with significant challenges which culminated in limb salvage surgery being undertaken during a combined 15 hour operation. 

The Plastics side of this operation was led by Mr Cotrufo. When my case was presented to him prior to surgery, it had been considered from the Plastics side that my leg could not be saved. However by soft tissue coverage using a local rotational flap (part of my calf muscle), as well as a free flap transfer from my left thigh to my lower right leg, he found a way to restore the vascular supply to enable my leg to be saved. Following surgery I remained in hospital for 6 weeks, the first half of this was spent in ARI, and the second half was in a hospital nearer my home town when I was placed under the care of Consultants at Glasgow Royal Infirmary (GRI). I initially progressed very well. 

Unfortunately my recovery was long and protracted due to the internal fixation in my leg progressively failing requiring an external frame to be fitted, almost 1 year after my initial injury. This was another complex operation which again presented significant challenges for both Orthopaedic and Plastics teams as it required areas beneath flaps to be accessed to remove the broken metalwork. It was explained to me that because it had been a particularly nasty injury, the ends of my bone had been stripped of blood supply at the outset resulting in them being unable to heal properly. 17 months after my initial injury my fracture had finally healed and the external frame was removed. In total I had required more than 22 hours of orthopaedic and plastic surgery and I continued with my extensive physiotherapy sessions which lasted 33 months. My sincere gratitude extends to everyone involved in my recovery through our incredible NHS, particularly at ARI and GRI, without whom I would not be as I am today.

Although my free flap has been complimented by medics, I wanted it reduced in volume so that I could fit better into everyday clothes and feel better about myself. Debulking was not an option through the NHS. In January 2019, I met with Dr Cotrufo at his London Clinic to discuss what, if anything, my options were. He explained that debulking the free flap may be possible using VASER Liposuction, what the risks involved in this procedure were and how these can be reduced as my vascular supply cannot be compromised. 

He was also clear on what my outcome could realistically be so as to manage my expectations. Firstly I required a CT scan to determine if any reduction was possible. It was good news, the CT scan showed it could be done. So now, more than 3 years after my initial injury, I am attending Dr Cotrufo’s Clinic to progress matters. My treatment is being done very gradually in a staged approach of VASER Liposuction to reduce risk to my vascular supply, whilst also using Platelet-Rich Plasma (PRP) injections 4 to 6 weeks before and after each procedure (the PRP injections are to encourage vascular growth). I have now completed the first session of VASER Liposuction which was undertaken at Harley Health Village hospital. I am very pleased with the results so far.

Dr Cotrufo is an exceptional plastic surgeon, with outstanding skills and expertise which extend far beyond the specialism of cosmetic surgery. My best chance of a successful outcome is with him, which is why I am travelling from Scotland to London for this treatment. I cannot recommend Dr Cotrufo highly enough.