The complex area for reconstruction of the head and the neck is the buccal because of difficult anatomy of this region. This article aimed to describe our individualized design for the reconstruction of the buccal using an different categories anterolateral thigh (ALT) flap. Ninety-four patients were involved in this study. Among 94cases, the number of using the musculocutaneous ALT flap was 57, using the fasciocutaneous ALT flap was 25, and using the thin ALT flap was 12. Postoperative vessel thrombosis occurred in 8 flaps, and required operative exploration in the perioperative period, 6 flaps were complete survival after the salvages, 2 flap was failure. The ALT flap represents a very good choice for the reconstruction of the complex defects at the cheek level. The flap can replace large volumes of tissues and the skin island is large and can be used both for the tegument reconstruction and for the oral mucosa reconstruction. Address correspondence and reprint requests to Dr. Guowen Sun, Department of Oral and Maxillofacial Surgery, Nangjing Stomatological Hospital,Medical School of Nanjing University,30 Zhongyang Road, Nanjing 210008, PR China; E-mail: guowensun@yahoo.com Received 3 September, 2017 Accepted 5 January, 2018 LZ and TZ contributed equally and should both be regarded as first authors. This research was supported by Jiangsu Provincial Special Program of Medical Science (BL2013005), Project of Health Department of Jiangsu province Nanjing science and technology development project (H201441), Nanjing science and technology development project (201503038) and Key project supported by Medical science and technology development Foundation Nanjing Department of Health (Ykk13150). The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.
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