Background: The free fibula osteoseptocutaneous flap remains the first choice for segmental mandible and contiguous soft-tissue defect reconstructions in most situations.
Methods: Several important principles are described that should be respected during skin paddle design: fibula contouring, insetting, and fixation, and dental implant osseointegration. Recent advancements that address difficulties in height contouring, particularly at the anterior segment, are highlighted.
Results: The presented methods can help provide an optimal mandibular reconstruction that restores mechanical functions, facial aesthetics, and complete dental competence.
Conclusion: Efficient interdisciplinary communication and teamwork are necessary throughout the longitudinal care of the patient if optimal results are to be achieved.