urgical reconstruction of soft-tissue defects in the knee, popliteal fossa, and upper lower leg area is a challenging task. One has to not only restore an aesthetic appearance but also enable proper function. Because of the limited availability and mobility of the adjacent skin, defects involving these areas often require complex reconstruction procedures.Many techniques, such as skin grafting, local skin flaps, pedicled muscle flaps, and free flaps, have already been described for the reconstruction of these regions; however, these regions should optimally be repaired using thin and pliable flaps. Based on basic plastic surgery principles to replace "like with like" with minimal donor-site morbidity and without sacrificing a major vessel, perforator flaps designed from the medial calf area represent a viable option. In particular, the medial sural artery perforator flap, which is harvested from this region, is therefore ideal for the