Burn reconstruction often requires innovative and more complex approaches to reconstruction, especially when there is a paucity of local tissue and typical flap reconstruction is unable to be performed. One such method is utilizing flap prefabrication and prelamination [3, 6, 8, 9, 11, 16, 17]. Prefabrication was first introduced by Shen [14] in 1982 and describes the implantation of a vascular pedicle into a new territory, followed by a period of maturation and neovascularization, and then the subsequent transfer of tissue based on its implanted pedicle allowing a significant amount of tissue to be transferred from one location to the area being reconstructed, greatly expanding our reconstructive options [11]. Flap prelamination, first defined by Pribaz and Fine in 1994 [8], describes the process of implanting either tissues or devices into a vascularized region, which can subsequently be transferred on its own axial blood supply but now with added support, lining, and structural components for layered reconstruction [9, 12]. In this chapter, we present the techniques of flap prelamination and the prefabrication as well as their usage in burn reconstruction.