Figure 1: a) 61-year-old gentleman with a left buccal squamous cell cancer with a history of betel nut chewing over several years. The intra-operative view shows the large soft and hard tissue defect after the oncologic resection. b) Early post-operative view after defect coverage with a double free flap (free fibula flap to restore the mandible defect and free ALT flap to cover the soft tissue deficit).