OBJECTIVE The reconstruction of the lower lip defects which may result from malignancy, trauma, and burn is necessary for mastication, oral competence, salivary retain, articulation, and aesthetic appearance of the face. While small (30% of the lower lip) and medium (30%-80% of the lower lip) size defects are reconstructed using primary repair and local flaps, reconstruction of the large defects including total and near-total of the lower lip is very challenging entity. We introduce a new modification of the fan flap named extended fan flap for reconstruction of the total and near-total lower lip defects. METHODS The extended fan flap was used for 12 patients with defects involving more than 80% of the lower lip due to squamous cell carcinoma excision. Most of the patients were males (80.9%) with an average age of 66.8 years (range, 47-82 years). RESULTS No major complication is observed in the postoperative period. The functional and aesthetic results were satisfactory. The sphincter function for normal mastication, eating, and salivary retain was reestablished. No microstomy was seen and insertion of artificial dentition was possible for patients. CONCLUSIONS We believe that the unilateral extended fan flap is a reliable and safe option with satisfactory functional and aesthetic results for total and near-total (more than 80%) lower lip defects.