Objective — to eliminate complex combined orofacial defects in patients with malignant neoplasms of the head and neck after surgical treatment. Subjects and methods. In 1992 to 2015, the P.A. Herzen Moscow Oncology Research Institute reconstructed the maxillofacial region after radical removal of malignant tumors in 172 patients. 203 autografts including visceral, osteomyocutaneous, musculocutaneous, and fasciocutaneous ones were used to eliminate defects. 29 autografts were employed in 29 cases. The paper describes clinical cases of simultaneous one-stage lower face reconstruction using two microsurgical autografts, long-term multistep reconstruction with two autografts, and delayed elimination of midface defect with a chimeric autograft. Results. Functional rehabilitation was performed in 83% of the patients in the total group of patients. The lowest rehabilitation rate (69%) was seen in the group of patients with combined defects of the mandible, oral cavity, oropharynx and soft tissues. Simultaneous one-stage reconstruction including that using several autografts, provides the best anatomical and functional rehabilitation as soon as possible after removal of the tumor and it is preferred to ensure the quality of life in a patient. Conclusion. The choice of grafts and their number depend on the composition of tissue, the functional significance of restored tissues, and the complexity and size of a defect. The use of two grafts to eliminate complex combined defects is the method of choice and yields the best functional result. Simultaneous reconstruction is advisable in patients at a low risk for recurrent tumor in its noninvasive growth, in those with high tumor differentiation and it can be done at hospitals that have surgical oncologists, who are trained in treating head and neck tumors and reconstructive microsurgery, and anesthesiologists.