Head and neck defects represent one of the most complicated clinical problems and is a great challenge for reconstructive surgeons because of the involvement of vital structures and important functions such as airway protection, speech, and swallowing. Head and neck surgeries may also cause changes of facial structures that directly affect their appearance. The extensive use of radiation therapy further adds complexity in wound healing and reconstruction. Providing basic tissue coverage for these defects without considering the functional and aesthetic outcomes is no longer acceptable in modern-day practice. Proper reconstruction of such defects may prevent life-threatening complications, restore essential functions, and improve the quality of life andself-image of patients. Local flaps are usually inadequate for large defects, particularly because ofthe need for radiotherapy making local flaps lessreliable. Reliable coverage of defects and vital structures are the fundamentals for head and neck reconstruction. Therefore partial flap necrosis,which is more commonly seen with local flaps orpedicled flaps, is not well tolerated in head andneck reconstruction because it may cause exposure ofvital structures and delay of adjuvant therapy.