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BACKGROUND:End to end vessel anastomosis was priority for revascularization in most conventional free flaps.And we paid less attention to the recipient vessels preservation.However, for perforator flaps which were popular now with small vessel caliber, an end-to-side technique to the recipient artery and vein will fulfill both the need to spare the recipient vessel and provide a better technique for unmatched vessel anastomosis.The aim of this study is to discuss the feasibility and reliability of the end-to-side arterial and vein anastomosis by comparing it with the end-to-end anastomosis in terms of anastomosis time, spasm occurrence , incidence of thrombosis , and overall flap survival.