Virtual surgical planning (VSP) applicability has recently expanded to include midface reconstruction with free tissue transfer. For the midface, an area that is crucial both functionally and aesthetically, even minor reconstructions (in the millimeter range) can make profound differences in form and function. The use of VSP allows the surgeon to improve accuracy and precision in areas where millimeters drastically impact outcomes. This review focuses on complex midface reconstruction requiring free tissue transfer and assesses the role of VSP in this patient population.