We present 14 free flap transfers, 9 of which were completely successful (74 percent), two of which were partial successes (14 percent), and 3 of which were failures (22 percent). All the 5 cases involving free flaps to the head and neck region were successful. In the 9 cases involving free flap transfer to an extremity, 4 were completely successful (44 percent), two were partially successful (22 percent), and 3 were failures (34 percent). Many factors determine the success or failure of free flap transfer, but two that seem most significant are (1) the technical expertise and experience of the surgeon, and (2) the quality of the vasculaturein the recipient bed.