The perforator flap is a new technology for oromaxillofacial head and neck soft tissue reconstruction. The flap is also a new development in microsurgery. By minimizing any muscle harvesting and trauma, perforator flaps aim to minimize donor site morbidity. Methods of locating perforating vessels for the use of perforator flaps are described in detail. In these methods, the small size of blood vessels and their variation are considered. Intraoperative careful vascular dissection and anastomosis are important for successful flap transplantation. This review will present the principal perforator flaps, particularly those used in oromaxillofacial head and neck reconstruction, including the anterolateral thigh flap, deep inferior epigastric perforator flap, and thoracodorsal artery perforator flap.
