Objective: Reconstruction of entire lower lip defect is still challenging in head and neck reconstructions.The unique structure of the lower lip includes intraoral mucosa, vermillionborder, muscle and facial skin.Without proper reconstruction of the defect, not only will the aesthetic outcomes be compromisedbut also functional outcome too, for example, lower facial deformity, microstomia and saliva drooling.The purpose of this article is to describe the evolution of the microvascular technique of using radial forearm free flap combined with pedicle tongue flap for the reconstruction of total lower lip defects.