Aesthetic and Psychological Benefits of Bipaddle Pectoralis Major Myocutaneous Flap in Oral Cancer Reconstruction

Background: Oral cancer reconstruction often overlooks aesthetic and psychological outcomes, impacting patients’ quality of life. Bipaddle Pectoralis Major Myocutaneous Flap (PMMC) is an effective alternative to traditional methods. Purpose: The study aims to highlight both the functional benefits and the positive impacts on patients’ aesthetic and psychological well-being, emphasising the importance of confidence, social acceptance, and mental health in reconstruction outcomes. Materials and Methods: A retrospective observational study was conducted on 50 OSCC patients who underwent tumour resection followed by reconstruction with bipaddle PMMC flaps in the Department of Surgical Oncology from September 2022 to October 2024. Patients were assessed at 6 and 12 months postoperatively using multiple validated instruments, including FACE-Q, Patient and Observer Scar Assessment Scale (POSAS), Derriford Appearance Scale-24 (DAS-24), Functional Assessment of Cancer Therapy–Head & Neck (FACT-H&N), and European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 with H&N35 module. Results: At 12 months, significant improvements were observed in scar quality, with mean POSAS scores decreasing, indicating better healing and cosmetic appearance. FACE-Q domains related to facial appearance, psychological well-being, social function, and eating function showed marked improvement. DAS-24 scores demonstrated reduced appearance-related distress, anxiety, and self-consciousness. FACT-H&N and EORTC QLQ-C30/H&N35 scores reflected enhanced physical, functional, and social well-being. Strong positive correlations were noted between FACE-Q and FACT-H&N (ρ = 0.72), FACE-Q and QLQ-C30 (ρ = 0.75), and a significant inverse correlation between FACE-Q and DAS-24 (ρ = -0.68). Conclusion: Bipaddle PMMC flap reconstruction following oral cancer resection offers substantial aesthetic and psychosocial benefits, with improved functional outcomes at one year. This technique remains an effective and reliable option for complex head and neck defects, particularly where microvascular free tissue transfer is not feasible.