The purpose of this article is to present an innovative technique in harvesting the pectoralis major myocutaneous flap (PMMC) which is very useful for reconstruction of post-ablative full thickness defects of cheek in elderly female patients. This is a prospective study of patients who underwent reconstruction with PMMC flap for post-ablative full thickness defects of the cheek and mandible in a tertiary cancer center over a period of 36 months. Sixty patients were included in the study. Mean duration of the hospital stay was 12 days. Eight patients (13.33%) had minor wound dehiscence, 6 (10%) had marginal skin necrosis of the flap, 2 (3.33%) patients had venous congestion, and 4 (6.66%) had wound dehiscence at the palate. Four (6.66%) patients had a gradual necrosis of the outer paddle. Our modification of elevation of the PMMC flap prevents its shearing which is especially useful in raising this flap in elderly female patients affected with advanced oral cancer.