BACKGROUND A series of previously described but rarely used variations of the pedicled, extended or vertical rectus abdominis musculocutaneous flap (Extended RAM, VRAM) were reviewed. METHODS Skin paddle dimensions, ranged 8 to 28 cm in width and 10 to 35 cm in length, were used in five consecutive patients. Four flaps were placed deep to the inguinal ligament to repair the thigh as proximal to the knee region; the remaining one flap was passed transabdominally to cover the defect of the lumbar region. RESULTS No flaps necrosis were seen and in one case wound healing problems required minimal operative intervention. Successful transfer of the VRAM and extended RAM with low rate of complication for the thigh and lumbar region defects were demonstrated to be safe and reasonable options of flap reconstruction. CONCLUSIONS The flaps had the advantages of being robust and well-vascularized, easy and fast to harvest, and not requiring microsurgery experience.