Defects around the buttock and natal cleft in the perianal area, although rare, pose difficulties in reconstruction owing to the complexities of anatomical contour, location, functions of defecation and pressure bearing. We report a case of a midline defect following malignancy extirpation where local adjacent skin and subcutaneous tissue were centralised into the midline defect area. The principle of type III keystone perforator flap was used with two flaps harvested bilaterally, based on both superior gluteal artery perforators (SGAP) and inferior gluteal artery perforators (IGAP) thereby sparing the gluteal muscles. We could achieve a sensate, sturdy and aesthetically acceptable natal cleft in terms of the colour, texture and contour with continent anal sphincter. The flaps after harvest resembled slices of watermelon, hence may appropriately be called as "watermelon slice flap". [ABSTRACT FROM AUTHOR]