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Related Experiment Video

Updated: Mar 29, 2026

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

Babak Azizzadeh1, Kelly J Pettijohn2

  • 1Department of Head and Neck Surgery, University of California, Los Angeles, 9401 Wilshire Boulevard #650, Westwood, Beverly Hills, CA 90212, USA.

Facial Plastic Surgery Clinics of North America
|November 28, 2015
PubMed
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This summary is machine-generated.

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The gracilis free flap offers ideal facial reanimation for patients with a functioning facial nerve. This two-stage approach, using a nerve graft and flap, provides spontaneous and emotive facial movement.

Area of Science:

  • Plastic Surgery
  • Microsurgery
  • Facial Reconstruction

Background:

  • Facial paralysis significantly impacts quality of life.
  • Restoring facial animation requires functional nerve and muscle transfer.
  • The gracilis free flap is a well-established option for facial reanimation.

Purpose of the Study:

  • To review the utility of the gracilis free flap for facial reanimation.
  • To discuss the two-stage surgical technique involving cross-face nerve grafting.
  • To analyze outcomes and complications associated with this procedure.

Main Methods:

  • Detailed anatomical review of the gracilis muscle.
  • Discussion of surgical technique for flap harvest and inset.
  • Exploration of alternative neural sources, including the masseteric nerve.
Keywords:
AnatomyFacial reanimationGracilis muscle free flapOutcomesTechnique

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  • Comprehensive literature review of outcomes and complications.

    • Main Results:

    • The gracilis free flap, when combined with cross-face nerve grafting, enables successful facial reanimation.
    • Viable contralateral facial nerve is crucial for spontaneous movement.
    • Alternative neural sources can be considered based on patient factors.

    Conclusions:

    • The two-stage gracilis free flap procedure is an effective method for achieving emotive and spontaneous facial reanimation.
    • Careful patient selection and surgical technique are paramount for optimal results.
    • Further review of outcomes and complications supports its role in reconstructive surgery.