In 1983, Asko-Seljavaara first came up with the concept of “free-style” flaps, i.e., any flap could be dissected based on the existing and separable feeding vessels. In 1989, Koshima and Soeda explained theoretically flaps pedicled with perforator vessels for the first time, for which no muscle tissue or important vessel needed to be dissected in the donor site to reduce the damage to the donor and improve the reconstruction results and aesthetic appearance of the soft tissues in the recipient site. Koshima et al. successfully applied the anterolateral thigh perforator flap to clinical practice in 1993. With the introduction of functional surgery and the development of microsurgery, perforator flaps have been applied more and more maturely and extensively in clinical practice. However, there are often significant variations in the perforators, and the caliber, number, position of the point where the perforator comes out, and running direction of the perforators are uncertain. When a perforator flap is designed based on the past experience and relevant anatomical knowledge, the flap design is often changed during the operation because of the variations of perforator vessels, which leads to increased operation time or additional damage to the donor site and creates challenges for the precise design of perforators. Therefore, it is the key to the design of perforator flaps to understand the anatomic information of perforators by preoperative imaging.