via the ophthalmic, infraorbital, and deep facial veins communicates with the cavernous sinus Lymphatic system The most important lymph nodes in the area are the intraparotid, submandibular and the submental lymph nodes. The inferior and medial parts usually drain to the submandibular nodes while the lateral and upper parts to the parotid nodes. Other lymphatic nodes include buccal nodes and submental nodes. Innervaton The nerve supply of the cheek can be divided into sensory and motor systems. Sensation to the cheek is carried primarily by the second (maxillary) and third (mandibular) divisions of the trigeminal nerve (cranial nerve V). The facial nerve (cranial nerve VII) provides motor innervation to the muscles of facial expression. Reconstructive options The primary goals of cheek reconstruction include the restoration of native function, maximization of aesthetic outcome, and limitation of repair related morbidity. Implicit in this statement is the intent to re-established both internal and external coverage, expressivity, masticatory function and aesthetic contour and quality. Local flaps Anterior-based cervicofacial flap The advantages of this flap is that there is no need to skin graft the donor site and scars are placed at the natural skin folds. This flap is used for posterior and moderate-sized anterior cheek defects. Lower eyelid ectropion should be prevented, by minimizing tension and by overcorrection and suspension of the cheek flap to the lateral orbital rim. This anterior-based flap is supplied by the facial and submental arteries and advances upward from the cervical area and rotates forward. Posterior-based cervicofacial flap A posterior-based cervicofacial cheek flap is used for small and moderate-sized anterior cheek defects. This flap is used for reconstruction of small medial cheek defects next to the nose or lips. The flap is supplied by the superficial temporal artery and vessels in the pre-auriculair region. Locoregional flaps Anterior-based cervicopectoral flap Larger posterior or lower cheek defects up to 10 cm can be closed if the incision of an anterior-based cervicofacial flap is extended, converting it into a cervicopectoral flap, which moves neck and chest skin to the face. This flap is vascularized by the internal mammary perforators. Advantages of this flap are its good skin color, texture, hair-bearing match and the location of the scars at natural folds. Posterior-based cervicopectoral flap For larger anterior cheek defects, the posterior-based cervicofacial flap is continued inferiorly along the sternum, then laterally down across the chest, above the nipple and toward the axilla. This