For the past three decades, works concerning axillary reconstruction were merely dedicated to axillary hidradenitis  suppurativa. Other causes were neglected and many techniques were introduced to treat just the affected zone. Axillary reconstruction after major burn contracture can be complex necessitating the transfer of large area of skin to adequately resurface the whole axilla. In this article, 13 patients were operated upon for either major axillary contracture or for hidradenitis suppurativa. Three regional flaps were used on the 13 patients: the thoracodorsal artery perforator (TAP) flap, the scapular flap and the latissimus dorsi myocutaneous flap. The number of flaps performed was 15 in the 13 patients. The choice of the flap was dictated by the degree of scarring of the axilla and the adjacent skin. All flaps survived and an algorithm is suggested for the reconstruction of the axilla  based on the extent of axillary damage  and affection of adjacent tissues.