Objective: To explore the use of the contralateral full-thickness retroangular island flap for reconstructing midfacial through-and-through defects. Methods: Full-thickness retroangular flaps raised from the contralateral infraorbital region were used to reconstruct midfacial through-and-through defects in eight patients following the resection of skin cancers. The defects ranged in size from 4.5 × 5.5 cm to 6.0 × 8.0 cm (mean 5.78 × 6.06 cm). The skin and mucosa in the full-thickness flaps ranged in size from 3.0 × 9.0 cm to 4.0 × 12.0 cm (mean 3.50 × 10.25 cm) and from 2.0 × 2.0 cm to 2.5 × 3.0 cm (mean 2.19 × 2.69 cm), respectively. Results: All the flaps survived and no complications occurred. The patients were followed for an average of 9.0 months (range 6-13 months). The vascularity of the flaps was good and the colour and texture matches were excellent. Cosmetic and functional outcomes were satisfactory in all patients. Conclusion: The contralateral full-thickness retroangular island flap containing the angular vessels in the pedicle is technically simple to use and is a good alternative for the reconstruction of moderate to large midfacial through-and-through defects. Keywords: retroangular flap, orbitonasolabial flap, nasolabial flap, cheek defect