Shallow upper buccal sulcus deformity, one of the secondary deformities after cleft lip-palate repair, causes both aesthetic and functional problems. This deformity also prevents or makes difficult orthodontic and prosthodontic procedures. An upper buccal sulcus deepening procedure was performed in 14 patients during the last 5 years. In 12 cases, premaxillary-based mucosal flaps were combined with one of the following: lip re-repair, Abbe flap, or bilateral buccal mucosal advancement flaps; in two cases, premaxilla was grafted wit buccal mucosal graft together with bilateral buccal mucosal advancement flaps. The follow-up period was 2 to 5 years. Results were satisfactory for the surgeon, orthodontist, prosthodontist, and the patient. Upper buccal sulcus reconstruction with premaxillary thin mucosal flap or full-thickness mucosal graft combined with tissue-sparing techniques provides successful and durable results.