Care of the reconstructed hand following mutilating injury is akin to the care of a vintage car. Its mechanisms are delicate, spare parts are limited, touch-ups are required often, and a major overhaul is indicated rarely. Secondary interventions are indicated for completion of staged primary procedures, management of complications, targeted improvement of function, and enhancement of appearance of the reconstructed hand. The approach to secondary reconstruction depends on the patient’s age, and vocational and recreational requirements. It is also influenced by the constant evolution of surgeons’ reconstructive philosophy, experience, and technology.