Plastic Surgery has been focussing on wound healing and therefore also on angiogenic regulatory mechanisms since many years. Nowadays most of the pioneering work including different plastic surgical techniques like tissue transfer and microsurgery are surgical standard. But only since 10 to 15 years we have tools and methods to investigate the molecular mechanisms of functional angiogenesis in vivo. This article presents some mechanisms and therapeutic strategies for angiogenesis, which can be applied both clinically and experimentally in plastic surgery.