A severely depressed deformity of the buccal region was repaired with an osteocutaneous flap based on the deep inferior epigastric vessels. This osteocutaneous flap has not been previously described in the literature. The superior pubic ramus, supplied by pubic branches from the deep inferior epigastric vessels, forms the bony portion of the combined flap. The cutaneous portion is also supplied by the deep inferior epigastric vessels and its thickness can be adjusted. This combination is useful when requiring both a thin flap and a flat bone.