The anterolateral thigh (ALT) flap has gained widespread popularity in head and neck surgery. Its benefits include a long vascular pedicle, a large but not-too-thick skin island, and a donor site sufficiently far from the head to enable two-team approaches. The descending branch of the lateral circumflex femoral artery (LCFA) is thus commonly used as an artery for anastomosis, but the main trunk is used when the pedicle length is short or the descending branches are included in flaps such as chimeric flaps. The LCFA often has a large vessel diameter, making anastomosis between flap and recipient vessels in the neck area difficult due to small recipient vessel diameters. In this report, we present the reconstruction of a buccal mucosal defect (after buccal cancer resection) using a transverse LCFA branch as a donor artery, which matched the recipient facial artery in diameter and thus facilitated simpler end-to-end anastomosis. The transverse LCFA branch is therefore a reliable donor artery choice for ALT flaps.
