The perforator flap is not a new concept in microsurgery but there is still confusion. The number of centers that is using these flaps for various indications is increasing. Studies about the differences between these flaps and the conventional flaps, including donor site morbidity and long-term follow-ups, will be seen in the medical literature. Better accuracy in reconstruction, including the use of only cutaneous tissue, minimization of the morbidity, and preserving the same survival rate in free flaps are reassurances to microsurgeons to perform perforator flaps. We believe that in the near future with refinements in the techniques and instruments, perforator flaps will be the first choice flap.