Pelvic Perineal Reconstruction Surgery at Stanford

Pelvic and perineal reconstruction restores soft tissue, structure, and function to the pelvic region following cancer surgery, trauma, or congenital defects. At Stanford Plastic & Reconstructive Surgery, our surgeons specialize in complex reconstructions that promote healing, restore body contour, and improve quality of life. Each surgical plan is carefully tailored to address both functional and aesthetic needs, often in collaboration with colorectal, gynecologic, and urologic specialists.

Stanford offers both local and microsurgical free-flap reconstructions. Local flaps are used when nearby healthy tissue can be advanced to close a wound, while free-flap techniques move tissue from other parts of the body, such as the thigh or abdomen, using microsurgery. These approaches provide durable coverage, improve healing after radiation, and help restore function to the pelvic area.

Flap-Based Reconstruction

Flap reconstruction uses well-vascularized tissue to fill defects and support healing in areas affected by prior surgery or radiation. Common options include the anterolateral thigh (ALT) flap, gracilis flap, gluteal flap, or vertical rectus abdominis myocutaneous (VRAM) flap. Stanford’s microsurgeons are experts in tailoring flap selection to minimize donor-site morbidity while achieving reliable results.

Multidisciplinary Reconstruction After Cancer Surgery

For patients undergoing abdominoperineal resection (APR), pelvic exenteration, or other cancer-related procedures, reconstruction helps restore pelvic stability and prevent complications such as infection or herniation. Our surgeons work closely with oncology teams to plan reconstruction at the time of tumor removal, optimizing both functional recovery and appearance.

Radiation and Trauma Reconstruction

Radiation therapy and traumatic injury can cause long-term damage to the pelvic soft tissues, leading to chronic wounds or fistulas. Stanford’s reconstructive team uses vascularized tissue transfer to bring healthy blood supply to damaged areas, promoting healing even in previously irradiated or scarred regions.

Stanford’s pelvic and perineal reconstruction program treats both cancer-related and non-oncologic conditions requiring soft-tissue restoration.

Common conditions and treatments include:

• Soft-tissue defects following colorectal, gynecologic, or urologic cancer surgery

• Pelvic and perineal wounds after radiation or infection

• Perineal hernias or structural defects

• Reconstruction after pelvic trauma

• Flap reconstruction (ALT, VRAM, gracilis, gluteal, or thigh flaps)

• Complex wound closure and fistula repair

• Multidisciplinary oncologic reconstruction

Stanford’s reconstructive surgeons are leaders in complex pelvic reconstruction, combining microsurgical precision with a collaborative, multidisciplinary approach. Our partnership with surgical oncology, gynecology, and urology ensures seamless coordination from tumor removal to reconstruction. Patients benefit from world-class surgical outcomes and compassionate, comprehensive care.

During your consultation, your surgeon will assess your medical history, prior treatments, and reconstructive goals. For cancer patients, surgical planning is integrated into your overall treatment schedule to minimize delays and optimize healing. After surgery, our team provides ongoing follow-up to monitor recovery and support wound healing, mobility, and long-term comfort.