The Keystone perforator island flap, invented by Australian surgeon Dr Felix Behan and first published in 2003, is essential in the arsenal of any reconstructive surgeon. The flap design is highly robust and immensely valuable for closing skin defects of the lower limb following tumour removal. Check out the step-by-step educational video at Wiki Plastics and original article in the ANZ Journal of Surgery. Full Video can be found here:http://wikiplastic.surgery/keystone-flap/. Behan FC. The Keystone Design Perforator Island Flap in Reconstructive Surgery. ANZ J Surg. 2003 Mar;73(3):122-20. doi: 10.1046/j.1445-2197.2003.02638.x.