The superficial cervical artery (SCA) fasciocutaneous flap was first reported by Nakajima et al. in 1984 [1]. In 1990, Hyakusoku developed it for use as a skin flap [2], and in 1993, we succeeded in harvesting it as a free flap [3]. Since the SCA is now considered to be a “transverse cervical perforator” or “trapezius perforator” (Fig. 49.1), this flap is widely known as the SCA perforator (SCAP) flap [4]. The cranial part of the trapezius muscle is thought to contain the SCA (i.e., the superficial branch of the transverse cervical artery) and the middle part of the dorsal scapular artery (DSA) (i.e., the deep branch of the transverse cervical artery) [4]. Given its wide arc of rotation, the SCAP flap is large enough to cover large defects after removing neck scar contractures.