Summary Severe alveolar atrophy is a common sequel to the extraction of teeth from the mandible. This atrophy, coupled with the associated superficiality of adjacent muscle attachments (Fig. 1a) precludes the provision of a stable, retentive prosthesis. This paper discusses some of the operations which have been designed to alleviate this considerable clinical problem and considers three aspects of the sulcoplasty procedure which in the author's opinion are crucial to its success. The paper also introduces the use of lyophilised porcine skin to dress the surface deficit created during surgery, thus obviating the need for skin grafting.