Traumatic facial bony defects present one of the most challenging problems for the facial plastic reconstructive surgeon. The most common mechanisms of trauma resulting in a bony defect of the facial skeleton include gunshot injuries, motor vehicle accidents, and burns. These bony defects of the facial skeleton resulting from trauma rarely occur in isolation. Rather, there is uniformly varying degrees of soft-tissue trauma and/or loss, potential visual, neurological and spinal injuries, and other associated life-altering implications. The application of free tissue transfer techniques to the management of these complex defects has allowed a significant change in paradigm, permitting early intervention and improved long-term outcomes.