In an era of perforator flaps, are muscle flaps passé?

As is not unusual with technological advances of any kind that invariably grab all the headlines, many previous standards of care, often without due consideration, are arbitrarily spurned as passé. Advocates of muscle perforator flaps vehemently insist this is now the ideal soft-tissue flap, in lieu of the traditional muscle flap, whose heyday of the past few decades is now over. Convincing arguments for the validity of this assumption can be made on the basis of the numerous attributes of muscle perforator flaps. A similar list of absolute as well as relative advantages, however, can still be compiled for "ordinary" muscle flaps. It should also be understood that both muscle and muscle perforator flaps have peculiar detriments as well that cannot be overlooked. The real truth is that both types of flaps have an important niche to fill, and together will permit a better overall solution, depending on the given reconstructive agenda. Are muscle flaps on a downhill course to obsolescence? The answer most simply is--never.