Objective. To demonstrate the results of multiplanar midface defect closure with complex tissue complex from thoracodorsal artery pool.

Material and methods. We present the results of multiplanar midface defect closure with complex tissue complex from thoracodorsal artery pool (latissimus dorsi muscle + serratus muscle + scapular angle). Flap components (bone/muscle/skin) are located in different planes according to planes and size of defect. All components are supplied through the vessels of thoracodorsal artery. In postoperative period, we analyzed aesthetic result, speech quality, intake of various food, flap functionality and incidence of postoperative complications.

Results. We obtained satisfactory functional results and good aesthetic effects.

Conclusion. Combined tissue flap has certain advantages for microsurgical reconstruction of maxillary and palatine defects (long vascular pedicle with large vessels facilitating microsurgical anastomoses, different tissue composition of the complex, variable tissue combinations in the flap, mobility of flap components, low incidence of atherosclerotic vascular lesions in scapular region unlike lower limb flaps and similar morphology of scapular and maxillary bone tissue).

Keywords. scapular tip flap, hard palate, microsurgery, reconstruction, oncology, maxilla, combined tissue complexes, maxillectomy