How to reconstruct the surgical defect is one of the major problems in the surgical treatment of the cancer of the head and neck. The pectoralis major myocutaneous flap(PMMF) which was independently introduced by Ariyan and Baek in 1979, has become one of the most versatile and reliable methods for reconstruction in this region. The authors successfully treated a patient who had a large through-and-through defect in the anterior neck and cervical esophagus after radiation and total laryngectomy, using a Janus falp, a PMMF with ""banked skin"".