“…For larger defects, an axial-based approach to the bilobed, allowing for larger flap dimensions and enhanced viability, has been described using the sural arteries [ 3 ]. However, when considering smaller defects, a random-pattern design can also be successfully executed and may be a better alternative [ 4 ]. The latter avoids axial-associated challenges, including – issues with the donor site, prolonged surgery times, and increased technical challenges – and when defect-dimensions allow, may be favored over muscle flaps, fasciocutaneous flaps, free flaps, and tissues expansion.…”