OBJECTIVE: Radiation therapy to treat hemangiomas is an old method that is no longer used due to its severe side effects. However, in Vietnam, radiotherapy has long been used to treat infantile hemangiomas, which has led to severe sequelae in adulthood. This article shares our experience in reconstructing the sequelae of radiation therapy for facial hemangioma using free anterolateral thigh (ALT) flap. MATERIALS AND METHODS: Six patients underwent facial lesion reconstruction using different ALT flaps, including volume augmentation, fascial, and thinning flaps. RESULTS: The largest flap used was 20 × 8 cm CONCLUSION: The ALT flap has several advantages, including flexibility in use, diversity in flap components, and minimal impact on the donor site, making it increasingly popular and effective.