Partial Muscle-Sparing Islanded PMMC in Head and Neck Reconstruction

India has a huge burden of head and neck cancer. Microvascular reconstruction is the gold standard currently. But it becomes difficult in each case. The pectoralis major myocutaneous (PMMC) flap has been the workhorse flap of head and neck reconstruction. Here, we describe a partial muscle-sparing islanded modification of the pectoralis major myocutaneous flap. Thirty-two patients with various head and neck defects underwent partial muscle-sparing modification of the pectoralis major myocutaneous flap from January 2022 to January 2023, with a follow-up period of 1 year. All patients did well with the flap, with only 1 partial necrosis, which was managed conservatively. The reach of the flap increased after it was islanded on the pedicle. The bulge in the clavicular region, typically seen with classic PMMC, was also absent, resulting in a symmetrical appearance of the bilateral clavicular region. Partial muscle-sparing modification of the pectoralis major myocutaneous flap is a useful modification which helps to increase the reach of the pedicle, improves aesthetics, is functionally better, and is an easy, repeatable modification with promising results.