Ballistic facial wounds present daunting reconstructive challenges to the most experienced of surgeons. The early Waltzing method of tissue transfer, perfected by Sir Gillies, was superseded by free flaps and facial transplantation as methods for facial reconstruction. In the low resource setting, however, the Waltz may be the only suitable option. This case study describes the use of the Waltz for facial reconstruction at the Port of Spain General Hospital in Trinidad. The subject sustained a gunshot wound to the face resulting in complex midface and mandibular defects. Here, bilateral deltopectoral flaps were used to replace destroyed soft tissue.
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