Features of application of atypical perforator flaps in complex anatomical areas (head and neck, mammary gland) were revealed. The methods of using typical and atypical perforator flaps were compared. We found that the use of non-typical perforator flaps increased surgery time by 30% compared with anatomically permanent flaps. However, non-typical approach was valuable for closing defects in anatomically complex areas without the use of free microsurgical repair. Mean difference between systolic and diastolic blood flow velocities in the perforator vessel may be predictive for dissection of optimal flap with no or minimal hemodynamic disturbances in rehabilitation period.