Successful reconstruction of massive lip defect requires restoration of both function and form, but it is the functional potential of the reconstruction that determines overall alimentary success. Unfortunately, static photography and patient surveys only approximate the degree of sphincteric reconstruction. What is needed is a simple method to display the dynamic movement of a lip reconstruction in order to appreciate the complex interplay between the remaining lip elements and the reconstructed lip. Digital videography was chosen to analyze results after several types of lip reconstruction. Using a Canon GL-1 3 chip digital camcorder, patients were filmed performing a series of standardized movements demonstrating sphincteric function. Standardized still images were analyzed in Adobe Photoshop using the ruler tool to quantitate movement of established landmarks. Movement was classified as absent, minimal, moderate, and normal (as measured in unoperated controls). Patients were divided into three groups: Free tissue transfer (free radial forearm), cheek advancement (Webster-Bernard procedure), and recruitment of remaining lip elements or circularization procedures (Karapandzic flaps). Representative patients in each group were studied. As expected, free flap reconstructed patients showed little movement in the reconstructed lip, while the remaining lip compensated to coapt the adynamic reconstruction. Cheek advancement patients demonstrated mild to moderate movement of the reconstructed lip segment, with a substantial degree of native lip compensation. Lip circularization patients displayed moderate to normal movements and sphincteric function, although stomal measurements were substantially smaller than the two other groups. Representative video will be provided for each group. In conclusion, free tissue transfer for massive lower lip reconstruction can provide a one-stage repair, but the sphincteric function is best when remaining lip is circularized. Digital videography provides a simple way to assess and display functional results after reconstruction of the lip sphincteric mechanism.