Reconstruction of the buccal defect poses unique challenges for the reconstructive surgeon. The prominent location on the face requires a refined and esthetic reconstruction. The intraoral component can heavily affect a patient’s function and quality of life. The dynamic movement of the area can contribute to complications in the postoperative period. As this region of the face can vary in its presentation and involvement of subunits and adjacent structures, the defect must define the reconstruction, and careful preoperative planning and design is just as important as the surgical execution.