Compared to the timeline of surgery the subspecialty of Head and Neck Reconstruction is young and only a few decades old. In the early eighties, the options of reconstruction were borrowed from management of war injuries, using complicated, multistage procedures, using tube pedicled flaps, regional pedicle flaps or even extracorporeal fasciocutaneous flaps. Reconstructions were often done as a secondary procedure, which resulted in compromised functions and aesthesis. A better understanding of the cutaneous and skeletal vasculature, opened the era of pedicled myocutaneous and fasciocutaneous flaps. The true revolution in head and neck reconstruction was brought in with microsurgical reconstructions. Initial focus was in achieving wound closure, ignoring aesthesis, function, and donor site morbidities. Presently the focus is on achieving aesthesis, function and in minimising donor site morbidities. The authors will present the development and progress in soft tissue Head and Neck reconstruction experienced in the past three decades. At Tata Medical Center since its inception in 2012, 2400 patients of head and neck cancer was operated of which microsurgical reconstructions have been undertaken in over 370 patients. Though conventional free flaps, such as Radial artery forearm, Anterolateral thigh are the backbone of soft tissue reconstruction, there have been dynamic changes in the approach in combining flaps to address the multi-dimensional component of each defect. Personal philosophies of the author in reconstructing soft tissue reconstructions will be presented. To mention TWO areas of work, that will be presented – A. The three dimensional nature of post resection defects in the Head and neck are difficult to address using conventional free flaps. Perforator based flaps with multiple components are closer in achieving these goals. Designing multiple islanded flaps based on perforator, provides chimeric tissues, addressing these three dimensional defects. Where adequate perforators are unavailable to design Chimeric flaps, combined flaps, from different territories may be fabricated by anastomosing perforators. B. Complex defects often require two or more flaps .Using two different donor sites, increases morbidity, increases operating time and stretches the manpower resources of the surgical team. The authors strongly believe that the donor site is a weak link in any reconstruction and hence limits the harvest to a single donor site. Combining ALT and Antero medial thigh flaps, making a single ALT flap into two based on its perforator anatomy, or using the proximal peroneal perforator flap combined with a fibula osteocutaneous flap addresses most soft tissue reconstructions. C. Soft tissue free flaps such as Lateral arm as well as SCIP( Superficial circumflex artery flap) will also be discussed. The author will walk through the present understanding in Head and Neck reconstruction, with a focus on 3 dimensional planning, using image guided planning, 3d printing ,perforator concept in designing multiple tissue components, and functional restoration using functioning muscle transfers in tongue and cheek reconstruction to provide animation, otherwise the so called FOURTH dimension.