Elaborate microsurgical operations are sometimes required for the treatment of complex soft tissue injuries. Plastic surgery offers a variety of such treatment options. These should always be considered when simpler reconstructive procedures failed to achieve the desired effect. Plastic surgery uses tissue units (like skin, connective tissue, muscle etc.) from one donor-area (for example the back, leg etc.) and microsurgically transfers them (as free flaps) for the coverage of substance or soft tissue defects on other recipient areas of the body. The tissue to be transferred is re- connected to the recipient area microsurgically so that vitality and perfusion are preserved and ensured as well. All tissue units that are to be transferred ( with the exception of sole skin transplantations) require an immediate connection with blood vessels on which their survival depends. For this reason an artery and vein at the recipient site should be exposed and with the tissue to be transferred (free flap) connected. In doing so, the blood supply is reconstituted, the artery can provide the newly transferred tissue with oxygen rich blood and the vein allows oxygen poor blood to flow out the flap and into the lungs so it can be once more loaded with oxygen. This technique allows the coverage of large tissue defects on the extremities, trunk or neck region.An exceptional feature of functional muscle flaps (for example the free gracilis muscle flap in the case of face paralysis or plexus lesions) is that they can be used to restore functional deficits,a result of past nerve damages, like the restoration of smiling in the case of face paralysis or elbow bending in the case of paralysis of the nervous plexus of the arm. With the employment of theses microsurgical procedures we focus and emphasize ,here in our Plastic Surgery Clinic in Berlin, on the appropriate treatment and medical care of complex soft tissue injuries and chronic wounds of every body part.