“…Free flaps are considered as the first option for complex or tridimensional soft tissue reconstruction in the H&N area, mainly the radial forearm free flap (RFFF) and the anterolateral thigh flap, both considered the workhorse flaps by H&N reconstructive surgeons [1][2][3][4][5]. However, some patients may not be suitable for free tissue transfer (FTT) because of older age, poor nutritional status, medical comorbidities, vascular problems often associated with high tobacco or alcohol consumption, the higher risk of prolonged surgeries [6], or the lack of recipient's vessels because of previous treatments, especially in patients with metachronous or recurrent tumors [7].…”