Lips may need to be repaired because of congenital malformations, benign or malignant tumors, or trauma. When a large portion of the lip is involved in the defect, or when this portion is cosmetically relevant, the repair may be particularly challenging and requires a perfect technique. We devised a surgical technique for the reconstruction of the vermilion that involves the use of a large portion of the mucosa vestibularis and of the underlying musculus orbicularis. The mucosa and muscle are taken from one lip and are rotated to cover the quantitative and qualitative defect of the opposite prolabium. Two stages are required in this procedure.