Expanded thin perforator flaps are an innovative surgical technique, designed to address the need for more precise and efficient tissue reconstruction. These flaps, thin layers of tissue that retain their blood supply through perforating vessels, offer several advantages over traditional flap techniques, including reduced donor site morbidity, enhanced aesthetic outcomes, and more predictable survival rates. This chapter explores the principles and applications of expanded thin perforator flaps, discussing their role in modern surgical reconstruction. In the field of reconstructive surgery, the expanded thin perforator flap has emerged as a promising technique for achieving both functional and aesthetic outcomes, with extremely large and thin flaps for reconstructing, especially in contour-sensitive areas such as the facial, cervical parts, and extremities.