The principal aim of reconstruction is to replace lost tissue with tissue with the best match in terms of size, shape, contour, colour and if possible function. This will require the flap/graft to be harvested from a site, which fulfils the above characteristics and places the secondary defect in the most advantageous position.

In the head and neck region, the flap is often harvested from a site adjacent to the defect for the “best” match. This requires sourcing flaps from areas with adequate tissue laxity and placement of scars along RSTLs, without causing distortion of the adjacent structures and landmarks.

The assessment of the defect will have to take into consideration the following: