Abstract
This article attempts to put perforator flaps, as they apply to head and neck reconstruction, into perspective. The importance of existing flaps is emphasized. Specific indications for perforator flaps are highlighted. The deep inferior epigastric artery perforator flap is used as the flap of choice for subtotal glossectomy defects by the authors. The anterolateral thigh flap is the most common flap currently used. Indications for its use are highlighted. Facial artery perforator flaps are introduced, and their roles as local flaps in head and neck reconstruction are highlighted. With our better understanding of vascular anatomy, existing flaps such as the submental flap have been recategorized as perforator flaps. Its role in reconstruction, particularly of lower facial defects, is discussed. Finally the internal mammary artery perforator flap is described and its advantages over the deltopectoral flap and the pectoralis major flap outlined.
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