As it applies for any other perforator flap, the main purpose of the thoracodorsal artery perforator (TDAP) flap is to allow raising of muscle-free, lipocutaneous flaps—which can primarily be thinned, if necessary—without creating any significance of donor site morbidity. The TDAP flap can be regarded as an evolution of the latissimus dorsi flap, having developed from a myocutaneous or pure muscle flap to a much thinner skin flap, which has many options for local defect cover or distant transfer. Whereas inclusion of the muscle makes dissection easy, a comprehensive search of the literature has shown that this procedure can lead to functional impairment of the shoulder, particularly during the early postoperative period, and to some shoulder strength weakness over time (Lee and Mun, Plast Reconstr Surg 134(2):303–314, 2014).