The size of the thoracodorsal artery perforator (TDAP) flap or pedicle, in general, may be found to be inadequate. Pre-expansion of the flap before harvest can be a solution to…

This article introduces pre-expanded super-thin intercostal perforator flaps, particularly the flap that has a perforator from the first to second intercostal spaces. The key techniques, advantages and disadvantages, and complications…

Internal mammary artery (IMA)-based pedicled perforator flaps can be used to reconstruct defects of the neck and anterior chest wall. Pre-expansion causes a possible delay phenomenon, improves flap survival, and…

The supraclavicular artery perforator (SAP) flap is a versatile flap for the reconstruction of head and neck defects. Recently, the authors have modified the SAP flap by using an anterior…

Patients with severe postburn scar contractures underwent reconstruction of skin defects after scar excision with pre-expanded super-thin skin perforator flaps supplied primarily by perforators via the “bridging effect” from the…

The vascular anatomy of perforators varies between individuals; thus, accurate preoperative assessment of perforators is essential for safely planning perforator flaps. Perforator computed tomographic angiography (P-CTA) with multidetector-row computed tomography…

Pre-expanded perforator flaps have several advantages over their traditional counterparts owing to the thin, more pliable nature, larger size, and minimum morbidity of the donor site. Recently, plastic surgeons have…

Pre-expanded perforator flaps, a combination of tissue expansion with perforator flaps, are emerging as another landmark of plastic surgery. This flap inherits the characteristics of both perforator flaps and expanded…

Robotic surgery has revolutionized minimally invasive surgery. Owing to its unique features and key advantages, robotic surgery is being used for complex cases across surgical specialties. It has been introduced…

Modern microsurgical techniques have made possible a broad spectrum of novel means for the reconstruction of complex bone and soft tissue defects. These techniques, in combination with developments in transplant…

Several methods can be used for identifying tissues for transfer in donor-site–depleted patients. A fillet flap can be temporarily stored in other parts of the body and transferred back to…

Pedicle perforator flaps and keystone perforator island flaps are additional tools for reconstructive surgeons. Advances in understanding of vascular anatomy, the dynamic nature of perforator perfusion, inter-perforator flow and the…

Use of the retrograde limb of the internal mammary vein has been described previously as a lifeboat for venous congestion but not prophylactically. Maximizing the length of the deep inferior…

Autologous breast reconstructions have grown in popularity because of their durability, aesthetic outcomes, symmetry, increase in external beam radiotherapy use, and potential aesthetic enhancement at the donor site. Increasing patient…

Head and neck reconstructive microsurgery is constantly innovating because of a combination of multidisciplinary advances. This article examines recent innovations that have affected the field as well as presenting research…

As microsurgical expertise has improved, allowing for the safe transfer of smaller and more refined flaps, free tissue transfer has continued to gain popularity for the management of pediatric soft…