In the field of plastic surgery, flaps refer to the tissue segment that can be used to cover a tissue defect or wound. The flap can consist of different components( for example skin and underlying connective tissue known as fasciocutaneous flaps, only muscle or also combinations of several tissues). This tissue segment/flap will be surgically dissected and transpositioned, rotated or stretched. Local flaps refer to the use of adjacent tissue to cover the defective area. These flaps (random pattern flaps) are so chosen and designed so that their blood supply is derived randomly from the network of vessels located in the area and not from a single longitudinal artery like in an axial pattern flap. Examples of a local flap is the rhomboid (Limberg) flap. This random pattern flap can be raised from any one or all corners of a rhomboid and fill a defect with tissue of the same thickness, color and with a good vascularity. Our Clinic for Plastic Surgery in Berlin belongs to the very few clinics that specialize in the microsurgical preparation of such tissue flaps. In the case of local flaps it is possible to raise the tissue units together with skin, connective tissue and muscle, and shift it over the adjacent defective area. Sometimes the flap has to be rotated around itself in order to cover the neighboring tissue defect. Flaps that are located near to the defect but do not share a side with it are called regional flaps.