This book serves as a comprehensive resource for everyone involved in microsurgical tissue transfer, including plastic surgeons, ENT surgeons, oral and maxillofacial surgeons, and trauma surgeons, equipping them with essential knowledge for daily practice. The new fourth edition builds on the didactic approach of breaking down complex surgical procedures into a sequence of simple, manageable steps, guided by clearly defined landmarks specific to each donor site. For each flap, an anatomically guided, step-by-step approach is presented, prioritizing simplicity, safety, and reliability to ensure successful flap harvesting. Each step is illustrated with photographs complemented by detailed schematic color drawings, providing a clear understanding of the anatomy. Supplementary online videos provide detailed demonstrations of the surgical techniques. This edition also introduces the elevation of the ulnar forearm flap and includes a new chapter on the gracilis free flap, a dependable option for motor reinnervation in cases of facial paralysis. This fourth edition also includes two additional perforator flaps: the thoracodorsal artery perforator flap and the medial femoral condyle bone flap. The latter serves as an excellent donor site for craniofacial bony defects and has been specifically proposed for use in jaw reconstruction within the oral cavity. As with previous editions, the book serves as a concise and focused resource, providing invaluable information for any reconstructive surgeon.