With significant advances in and wider availability of microvascular techniques, free flaps, such as anterolateral thigh flap, are preferred for head and neck reconstruction in most cases. However, pedicled flaps are thought to be safer, easier, and take less time than free flaps. When free flaps fail or there is a limitation of free flap usage, pedicled flaps, such as pectoralis major myocutaneous flap, have an important role in the treatment of certain head and neck defects. In this case report, we report our experience of multiple flap failure. We ultimately used a two-staged latissimus dorsi flap using a supercharge technique. Normally, this method is not recommended due to its requirement of multiple operations and a poor esthetic result; however, it may be worth considering this technique in patients with significant risk factors for free flap failure.
