Perforator flaps represent the latest descendant in a line of evolution that began with the random pattern flap. The perforator flap era began in 1989 and they become more popular in plastic surgery because of many advantages: reducing of donor-site morbidity
they can be tailored to accurately reconstruct the defect, including flap thinning for resurfacing shallow defects
freedom of orientation of the pedicle and a longer pedicle
large territories flap. Indications for specific perforator flaps are dependent on many factors including the surface area and volume requirements, aesthetic appeal, patient choice, and the experience and repertoire of the surgeon.