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Related Experiment Video

Updated: May 22, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
19:53

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer

Published on: March 1, 2015

Lower lip reconstruction using a functioning gracilis muscle free flap.

Milomir Ninkovic, Stefano Spanio di Spilimbergo, Karen F Kim Evans

    Seminars in Plastic Surgery
    |May 3, 2012
    PubMed
    Summary

    The functioning gracilis muscle flap offers an ideal solution for reconstructing extensive lower lip defects, restoring symmetry and movement. This technique is recommended for significant lip resections, especially when combined with sensory restoration.

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    Area of Science:

    • Plastic Surgery
    • Reconstructive Surgery
    • Oral and Maxillofacial Surgery

    Background:

    • Large full-thickness lip defects pose significant reconstructive challenges for plastic surgeons.
    • Defects exceeding two-thirds of the lower lip typically necessitate complex staged reconstruction or distant tissue flaps.
    • Restoring lip function, including oral competence and emotional expression, is paramount.

    Purpose of the Study:

    • To evaluate the gracilis muscle flap as an ideal solution for complex lip reconstruction.
    • To define indications for using the functioning gracilis muscle flap in lip reconstruction.
    • To explore methods for restoring sensation in reconstructed lips.

    Main Methods:

    • Utilized free gracilis muscle flaps for lip reconstruction.
    Keywords:
    Facial artery musculomucosal flapgracilis muscle free flaplower lip

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    Last Updated: May 22, 2026

    Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
    19:53

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    Published on: March 1, 2015

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  • Innervated the flap with the facial nerve to restore dynamic movement and symmetry.
  • Incorporated a facial artery musculomucosal flap and sensory neurotization where possible.

    • Main Results:

    • The functioning gracilis flap achieved symmetric and simultaneous commissure movement.
    • The flap provided uniform lip movements, enhancing oral competence and expression.
    • Successful reconstruction was achieved for defects larger than one-quarter (younger patients) or one-third (all patients) of the lip length.

    Conclusions:

    • The functioning gracilis muscle flap is highly suitable for reconstructing extensive lip defects.
    • Facial nerve reinnervation is crucial for restoring dynamic function and symmetry.
    • Including sensory neurotization improves the functional outcome of lip reconstruction.