Extensively burned patients often lack ample healthy skin for skin grafts. We developed a method using several novel flaps composed of healthy skin left around recipient sites. In 1991, Hyakusoku et al. presented a propeller flap with a subcutaneous pedicle [1]. The original propeller flap was used in intact fossae to reconstruct the axilla or cubitus. The flaps were designed in the center of the fossa and elevated as island flaps. Hyakusoku et al. indicated that perforating vessels are often constant in their pedicles [1]. After this report, improvements such as the multilobed propeller flap [2] and scar band rotation flap [3] were introduced. A subcutaneous pedicle is located under the center of every flap, categorizing these methods as “central axis flap methods.” [4] Nowadays, the subcutaneous pedicle has been refined, and vascular (perforator) pedicle propeller (PPP) flaps [5] are now widely used. This PPP flap is discussed in another chapter of this book.