Ten cases of total lower lip reconstruction are reviewed. The total lip defects resulted from tumor resection (n=6), trauma (n=3), and noma (n=1). There were concomitant chin and mandible defects in three and four patients. The planning and choice of operative methods depended on the quality of the surrounding tissue and the patient's age, sex, occupation, and general health. Local procedures and tissue transposition from the head and neck region were used in eight cases; distant flaps were necessary in two cases. All patients achieved satisfactory functional and esthetic results. The author's experience and evaluation of various surgical methods are presented with special regard to the combined use of local and distant tissue to achieve an optimal outcome.