In recent years, many advances have been made in surgical fields of oral and maxillofacial reconstruction, and the variety and complexity of available surgical approaches consider different functionalities of the jaw and the aesthetics of the face. There is no validated or scientifically proven basis for deciding which flap to use for reconstruction, so decisions are often made based on the direct and indirect experiential knowledge of the reconstructive surgeon. Considering the modified ladder, elevator, and pie reconstructive options, their risk and donor morbidity, and their long-term outcomes, the simplest option that will achieve the best long-term outcome in terms of form and function and with the lowest donor morbidity should be chosen for the patient's health and social welfare. This manuscript summarizes current options for jaw and facial reconstruction and their limitations by offering updated guidelines for various defect conditions.
Keywords: Free flap; Guidelines in jaw and facial reconstruction; Head and neck cancer; Health and social welfare; Oral and maxillofacial reconstruction.