This seems to be a scene that only a “freak in disguise” can show up: opening a patient’s chest cavity and taking out a rib with pectoral muscle intact, which perfectly fills in the left side of his almost open face. Recently, the Department of Oral and Maxillofacial Surgery of the Second Hospital of Sun Yat-sen University has successfully saved a patient with advanced oropharyngeal malignancy by opening the chest to take out the pectoral muscle with a rib to fill the tongue and jaw. At present, the patient’s appearance, language and eating function have recovered well. Six months ago, Wei, who lives in Fangcun District, found that he had a tumor growing around his left tongue root and tonsils, and he had been to several hospitals for medical treatment, but failed to get proper treatment, and the tumor kept spreading, and the pain in the submandibular area at the bottom of the mouth was obvious, and even opening the mouth to speak was affected, and eating was quite difficult. In order to save the patient’s life, Wei was transferred to the Department of Oral and Maxillofacial Surgery of the Second Hospital of Sun Yat-sen University for treatment. After a thorough examination by the chief of the department, Dr. Pan Chaobin and other medical staff, it was found that Wei was suffering from oropharyngeal cancer, with his left tongue and tonsils surrounded by tumors, and his left mandible also destroyed. The patient’s condition was deteriorating and if not treated in time, the tumor would develop to block the mouth and pharyngeal cavity, resulting in the inability to breathe and eat. After 10 days of chemotherapy recovery, the strong technical force of the Oral and Maxillofacial Surgery Department of Zhongshan Second Hospital was organized to prepare Wei for a large radical surgery for oropharyngeal cancer plus tissue defect repair. The surgery was performed by a number of experts including Pan Chao Bin, Director of Oral (Cranial) and Maxillofacial Surgery, Professor Huang Hong Zhang, President, and Professor Zhang Hua, Deputy Director of Thoracic Surgery. After the tracheotomy and intubation of the patient with general anesthesia, the organized group surgery started. First, a group of specialists had to perform bilateral cervical lymph node dissection on Wei, then cut the lower lip and mandible along the midline of his chin to completely expose the oral and pharyngeal cavities, and remove the tissues that might have tumor metastasis in Wei’s left neck, left mandible, left tongue and peri-tonsil tissue in large pieces from the bottom up. After complete resection, a large cavity was formed in Wei’s left oral cavity and pharyngeal cavity. In order to repair this defective area, another group of specialists had to separate the patient’s left pectoralis major muscle with one rib. To ensure the blood supply to the rib, the specialists creatively opened the chest cavity to obtain a large piece of tissue consisting of the pectoralis major muscle and a rib with good blood supply. This tissue block with a complete vascular bundle was transferred upward along the left neck above the clavicle and placed in the oral pharyngeal cavity. In this way, the specialists skillfully repaired the left tongue, floor of the mouth and lateral wall of the pharynx with the pectoralis major muscle, and its ribs were joined to the right jaw, thus restoring the integrity of the jaw. The successful surgery was the first of its kind at home and abroad After eight hours, this extensive surgery from the thoracoabdominal junction to the jaw was declared successful. At present, Wei’s long surgical incision from the oral cavity to the thoracic cavity has completely healed, and the pectoral muscle in his oral cavity has become alive. A series of examinations showed that the blood supply to the rib bone transplanted to the chin was normal, and the chin form was also recovered ideally. It is understood that the transfer of the pectoralis major muscle with vascular tip to repair a large oral defect was only used clinically in 1979. However, since most of the large oral malignant tumors have invaded the mandible, simply repairing and reconstructing the soft tissue without repairing the mandible removed during surgery is bound to affect the patient’s appearance, oral and speech and eating functions. In contrast, cutting the pectoralis major muscle with ribs in an open-chest manner can ensure the blood flow to the ribs, so that the pectoralis major muscle and ribs can share the blood vessels from the same chest and shoulder peak. It is known that this surgical approach has not been reported in China or abroad.