Free fibula flap transfer, which consists of a vascularized segment of the long fibula, is the gold standard for mandibular reconstruction; however, this flap lacks sufficient soft tissue. In this report, we present a case of mandibular reconstruction in which the free fibula flap included two skin paddles vascularized by the proximal perforator（PP）and distal perforator（DP）. The two skin paddles provided sufficient soft tissue and improved the outcome in terms of reconstructing the facial contours with a single flap. The PP has anatomical variations in terms of（a）location, running through both musculo- and septo-cutaneous regions, and（b）bifurcation, originating from the peroneal artery or more proximal positions. As skin paddles involving the PP have slightly thicker fat tissue and larger soleus muscle tissue than those involving DP, they may be useful for supplying soft tissue in mandibular reconstruction.
