Background: Causes of acquired lower lip defects include trauma, tumours, infectious disease, and haemangiomas, amongst others. Squamous cell carcinoma (SCC) is the most common malignancy of the lower lips, and surgical resection with adequate margins is the mainstay of treatment. Goals of lower lip reconstruction following oncologic treatment are both functional and aesthetic. Functional goals include maintaining intraoral mucosa, avoidance of microstomia, maintaining orbicularis competence, and providing a sensate lip. Aesthetic goals include replacement of external skin, maintaining the balance of the vermiliocutaneous junction and lip aesthetic units. Objectives: ​​We present four patients who underwent subtotal lower lip defects for SCC resection, and who had reconstruction with a combination of locoregional flaps. Methods: Two patients had reconstruction with Karapandzic + Abbé-Estlander flaps, one patient had reconstruction with Karapandzic + Webster-Bernard flaps, and one with Karapandzic + local advancement flaps. All patients had >⅔ lower lip width defects post-resection. Findings: There were no postoperative complications of the lower lip reconstruction in the three patients. No patients reported oral incontinence post-surgery, and all were able to eat a normal diet on postoperative day 10 per the operating surgeon’s protocol. Conclusions: The use of combined local flaps for the management of lower lip defects >⅔ width allows for a single-stage procedure, while meeting the functional and aesthetic goals of lip reconstruction. This approach to reconstruction has not been previously described.