Plastic microsurgery, the past, present and future

SUMMARY: Plastic microsurgery is one of the key innovations of mo dern reconstructive surgery, enabling the precise treatment of complex tissue defects while preserving functional and aesthetic characteristics. The development of this discipline enables the performance of complex procedures such as free flaps, limb replantation, and reconstruction of blood microstructures and nerves. This work shows the historical development of microsurgery, from the pioneering works of Alexis Carrel and the introduction of vascular anastomoses, through the development of the operating microscope and the first replantations, to the standardization of free flaps and the emergence of perforator flaps and supermicrosurgery. Modern microsurgery increasingly relies on advanced radiological methods, digital technologies, robotics, and artificial intelligence, which improve precision, education, and treatment outcomes. Future development of these disciplines is directed toward integrating regenerative medicine, tissue engineering, and digital technologies, with the aim of further improving the functional and aesthetic outcomes of reconstruction. Despite the challenges, it is clear that microsurgery will continue to develop and improve the quality of life for patients.