Background:The defects resulting from head and neck tumor surgeries present a reconstructive challenge to surgeons.The submental flap is good method in head and neck reconstruction.However,this flap has the risk of having to give up because of anatomy variations,operator’s mistake and other reasons,even if it has been raised intraoperatively.This will fall the surgeons into an embarrassing situation.In this article,we present our experience in modified incision design of submental flap.This method outlines three flaps simultaneously.When we find the submental flap can not be used during the operation,we have two other alternatives.Combination with the retrospective analysis of this flap we performed,we hope this article will be helpful in expanding the awareness and application of this useful system of flap.Methods:According the incision outline overlap of submental flap,platysma myocutaneous flap and infrahyoid myocutaneous flap dissected respectively,we design a modified incision outline of submental flap.Firstly cut off the neck and inferior border of flap,complete the neck dissection of Ⅲ,Ⅱ and Ib area and identify the pedicle vessels.Then cut off the superior border of flap,raise the flap,in the mean time,complete the neck dissection of Ia.By this method,we reconstructed the defect of thirty patients from 2004to 2007,and these consecutive patients were retrospectively analysed.Statistics pertaining to the patients’ clinical factors were gathered.Results:The all thirty patients were performed by our modified method very easily.In these patients,twenty-seven had dissected submental flap finally,one was replaced as infrahyoid myocutaneous flap and two were replaced as platysma myocutaneous flap intraoperatively according this method design.In patients finally raised submantal flap,average age is 61.8years old;the patients exhibited a myriad of comorbidities;the size of the flaps ranged from 4cm × 2.5cm to 8cm × 6cm;the average operation time is 5.8hours;2patient developed full-thickness necrosis of the distal flap tip;the vast majority of patients (21/27,77.8% ) were satisfied with the results of their reconstructions;in 15patients followed up more than 5years,9patients with no recurrence (9/15,60%),the 3-year survival rate is 73.3% (11/15),and the 5-year survival rate is 60% (9/15).Conclusions:Submental flap is a good flap in reconstruction of head and neck defects.Our modified incision design is a versatile and reliable method to raise this flap,which can enhance the flap’s success rate,and will not influence patients’ survival rate.The surgeons can safely harvest submental flap by this method.