Squamous cell carcinoma is the most common cancer occurring in the oral cavity and oncologic wide cancer excision is a major cause of large lip defects. Large lower lip defect reconstruction with good functional and aesthetic results has always presented a challenge for plastic surgeons. There are various lower lip reconstruction methods depending on its size, location, and surgeon’s expertise. This is a case of a large defect spanning more than two-thirds of the lower lip after wide excision due to squamous cell carcinoma. The Karapandzic flap was used to reconstruct the defect with a commissuroplasty carried out in a second operation, which yielded a relatively good functional and aesthetic result. No recurrences or metastases were observed within a one year follow-up period.