The anterolateral thigh (ALT) flap was originally described as a septocutaneous artery flap by Song et al. [1]. Almost at the same time, the detailed anatomy of this flap and its clinical application were reported by two other Chinese doctors in a Chinese journal [2, 3]. The locations of the perforators on the skin were first reported by the author [4]. After that, the anatomy of this flap was further presented from cadaver dissections or clinical experiences [4–6]. It was found that the blood supply of the anterolateral thigh flap was based on the septocutaneous or musculocutaneous perforators, or both, the vascular variations of which were also reported by Koshima et al. [7].