The increasing necessity for solo surgery in plastic and reconstructive microsurgery is driven by contemporary challenges such as a growing and aging population, a shortage of qualified assistants, and the ongoing recovery efforts from COVID-19. Historically limited to remote or exceptional circumstances, solo surgery is now more frequently performed due to these evolving factors. Technological advancements, including robotics, play a crucial role in facilitating this transition and supporting the trend toward self-sufficiency in surgical practice. This article presents practical strategies for executing solo surgery based on our team's experience and a review of current literature. Key considerations discussed include patient positioning and optimizing surgical workflows. By presenting these recommendations and techniques, derived from both practical experience and literature, we highlight that plastic surgeons and microsurgeons can maintain consistently high standards of surgical care, even when operating independently.