Salvage surgery in head and neck carcinoma is often followed by dreaded postoperative complication. Reconstruction with free flap is usually the ideal treatment option. Here, we present the case of a 46-year-old man with necrosis of free flap in post-radiotherapy carcinoma buccal mucosa. The flap was thus taken down and was replaced by a large pectoralis major myocutaneous flap to cover the intra-oral defect and part of the facial defect. The area in front of ear was left bare, to be reconstructed after stabilization of the patient. Later, the patient was taken up for surgery and posterior auricular flap was used to cover the defect anterior to the ear. Astute knowledge of local flap with preserved blood supply is thus needed in post-radiotherapy cases with failure of free flap.