A method for the reconstruction of the bony chin contour with an iliac crest free flap is described. The skin pad may be used to replace mucosa or skin or both. Excessive bulk can be a problem, particularly where a relatively small bone and oral mucosal defect requires replacement. Attempts at minimizing this bulk risk the loss of blood supply to the overlying skin. Another procedure, such as the internal oblique-iliac crest osseomyocutaneous flap or inclusion of the thoracodorsal pedicle with the scapular osteocutaneous flap, should then be considered.