| Summary: | The fibula free flap (FFF) surgery has long been used for complicated mandibular reconstruction. Virtual surgical planning (VSP) has been incorporated into the reconstruction planning by surgeons and has been found to reduce operating time and surgeon stress intraoperatively. When compared to traditional reconstruction, VSP enhances accuracy, surgical efficiency, and clinical outcomes. However, VSP on the other hand, need advanced technology such as software and 3D printing equipment, which are not always accessible in all centres. We describe our workflow on VSP reconstruction of the mandible with FFF by using open-source software. Methods: Three patients underwent mandible reconstruction with FFF. VSP was used for all reconstruction planning. Results: The mean operative time was min 765 minutes (range: 615 – 960 minutes), the mean ischemic time was 260 minutes (range: 120 – 355 minutes) and the mean length of stay was 10.7 days (range: 10 – 12 days). There were no flap failures. There were no major complications. Conclusion: VSP is a very viable method that saves time and cost, making surgery more efficient.
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