Soft Tissue Reconstruction with Perforator Flaps

Perforator flaps have become increasingly popular among surgeons over recent years. They are an elegant solution to many reconstructive problems. For this reason, they are positioned near the top of the reconstructive ladder and are considered an elegant upgrade of musculocutaneous and fasciocutaneous flaps. Passive muscle and fascia1 carriers are no longer required to ensure flap vascularity, and, by virtue of their composition, perforator flaps permit excellent “like-for-like” tissue replacement with minimal aesthetic or functional donor morbidity. Perforator flaps are usually thin, pliable, easily moldable flaps that are well suited to resurfacing work. They are also ideal for reconstructing pliable organs, such as the tongue, or for molding to complex contours, as in head and neck surgery. Perforator flaps with large quantities of subcutaneous fat have proved ideal for reconstructing the breast.