ABSTRACT
The pectoralis major flap, first described by Ariyan in 1979, has often been considered by many as the workhorse reconstructive option for a medium to large surgical defect of the head and neck. The popularity of the flap has, however, diminished in recent years due to continued advances in microvascular free tissue transfer techniques. The pectoralis major flap is an axial patterned flap which can be raised as a myocutaneous or a ‘muscle only’ flap depending on the characteristics of the recipient defect. The pectoralis major muscle is a paired fan-shaped thick muscle on the anterior chest wall, originating from two sites: a clavicular head, from its sternal half, and a sternocostal head, extending from the sternum to the costal cartilages of the upper six ribs and sometimes up to the seventh costal cartilage. One of the more common complications of this flap is the partial or complete necrotic loss of skin paddle.
