flap is supplied by the superficial temporal artery and vessels, the vertebral and occipital arteries and the perforators of the trapezius muscle. Regional flap Platysma Musculocutaneous flap This flap can be used for various defects in the head and neck area. Based on the dominant blood supply there are three different variations of the PMF: superior, posterior or inferior based. Only the superior and posterior based PMF is suitable for oral and facial reconstruction. The thin, quadrangular shaped, and paired platysma muscles lie in the superficial fascia of the neck. Superior platysma musculocutaneos flap The dominant blood supply is from the submental branch of the facial artery and the venous drainage of the v. submentalis. The arc of rotation is suitable for reconstruction of the anterior and lateral floor of mouth, buccal mucosa, retromolar trigone, and skin of the lower cheek and parotid region. Posterior platysma musculocutaneos flap This flap receives its blood supply primarily from branches of the a. occipitalis. Venous drainage is the v. jugularis interna. The arc of rotation is suitable for reconstruction of the lower lip, floor of mouth, ventral tongue, and lower one third of the face. For the proper arc of rotation an adequate exposure of the muscle is necessary. Advantages of the PMF is that the platysma flap has an appropriate thickness, minimal donor- site morbidity, acceptable scar and colour match and it is easy and faster to harvest. During the procedure the neck is in a hyperextended position. Tissue expanders An adjunct to the utilization of local and locoregional flaps is the option of tissue expanders. They effectively increase the net skin surface area and provide skin that has the same texture, colour, and hair bearing qualities as the recipient site. Pedicled flaps Pedicled flaps are used when regional tissue is not available, for example because of burns or radiation. There are two pedicled flaps that are sometimes used for reconstruction of cheek defects with or without pre-expansion: Supraclavicular flap The supraclavicular flap, also known as the "epaulette" flap is vascularized by the surpaclavicular artery, which branches off the transverse cervical artery. The vessels can be found using a hand held doppler in the triangle between the dorsal edge of the sternocleidomastoid muscle, the external jugular vein, and the medial part of the clavicle. The flap can be raised as an island flap as well as a pedicled flap. Deltopectoral flap The