Reconstructive procedures of the head and neck aim to repair soft tissue and bony defects while restoring optimal function and cosmesis. Defects necessitating reconstruction may be the result of congenital anomalies, destructive disease processes, trauma, or surgery. Because primary wound closure is often impossible in these settings and healing by secondary intention provides unacceptable appearance and function, tissues from elsewhere in the body are usually mobilized to achieve the reconstructive goals. Reconstructions using tissue grafts and flaps have unique characteristics on postoperative imaging that differ from the original tissues being replaced, as well as the appearance of the donor size prior to transposition. As these reconstructive techniques become more sophisticated, it is crucial that physicians have an appreciation for current reconstructive methods.