The radial forearm flap was first reported by Yang et al. [1] in 1978. It is one of the most reliable conventional flaps for hand reconstruction. However, it is associated with donor-site morbidity, which includes problems due to major artery sacrifice, numbness of the dorsal hand, and the development of unfavorable scars. Consequently, many modifications of the radial forearm flap have been reported. These modifications have resulted in the expanded flap [2], the distally based flap [3], and the perforator-based flap/perforator flap [4–6] methods. In a further modification, we developed the “shape-modified radial artery perforator flap (SM-RAP flap) method” [7–9].