"Microleaps" in the progression of flaps and grafts

No momentous upheavals in the past decade have altered radically the knowledge or application of "flaps and grafts," but "microleaps" in slow and steady increments have ensured a continuum of progress. Fasciocutaneous flaps, owing to an intimate relationship with the superficial nerves, may be neurocutaneous flaps in disguise. Distal-based flaps that recruit orthograde circulation may be made even more reliable for extremity coverage in lieu of complex microsurgical techniques. As success at the recipient site has not become so routine, further outcome improvement has been directed toward enhancing the appearance and residual function at the previously neglected donor site. The future of plastic surgery will continue to parallel advances in the principles of flaps, constrained only by the boundaries of imagination.