While microvascular reconstruction of large oncologic defects of the head and neck is an established, reliable technique, issues of operative time and patient morbidity require consideration. While there has been some resurgence of regional flap reconstruction of equivalent defects, their widespread use has been limited due to limited training and lack of precise, practical techniques in the medical literature. The development of the regular use of regional flaps in a busy microvascular reconstructive practice will be presented, with specific emphasis on the submental and supraclavicular island flaps. Step-by-step harvest will be demonstrated, and representative cases presented. The objective is to show the successful harvest of the flaps, as well as their range of use and limitations. At the conclusion of the session, participants should not only have a better understanding of how and when to utilize these flaps in reconstructive practice, but more importantly have a better grasp of the the practical side of how to embark upon their usage.