Microvascular flap reconstructions of facial and mandibular defects are achieving increasingly widespread application and, as a result, more patients are considered for such procedures after large tumors, congenital abnormalities, previous surgery (including failed and successful microsurgical procedures) and radiation have compromised potential recipient vessels on the side of the defect. In three such cases, contralateral facial vessels with vein grafts have been used to provide flap-recipient vessels. Each flap was successful. Cross-facial vein grafting is a relatively simple solution for utilizing undamaged vessels as recipient pedicles in complicated flap reconstructions of the face and mandible.