Objectives: To evaluate whether the extent of tumor resection and free flap reconstruction influences functional outcome and complications in patients with solid malignancies of the cheek. Design and Participants: We retrospectively assessed recipient site complications and functional outcomes in 47 patients with solid malignancies of the cheek who underwent either partial (n=30; 63.8%) or full-thickness (n=17; 36.2%) cheek resection with free flap reconstruction. Setting: Retrospective, multicentric analysis Results: Full thickness resections with creation of through-and-through defects were not associated with significantly higher complication rates (70.6% vs. 46.7%; p=0.138) compared to partial defects. Recipient site complications occurred in 55.3% of patients and were noticed most likely after reconstruction of suborbital defects (69.2%; p=0.268) of which occurrence of salivary fistulae was the most common (46.2%; p=0.035). Similarly, functional outcomes including oral incompetence, ectropion, and trismus were not affected by the extent of resection (p=0.766). However, oral incompetence was higher in patients with tumors originating from oral cavity (p=0.020) and after the performance of mandibulectomy (p=0.003). Conclusions: There was no difference in functional outcome or recipient site morbidity between tumor resections resulting in full-thickness and partial defects.