Related Experiment Video
Updated: Aug 17, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
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.
Abstract:
The gracilis free flap is the ideal modality of emotive and spontaneous facial reanimation in patients with a viable contralateral facial nerve. A 2-stage procedure with a cross-face nerve graft followed by gracilis free flap inset is advocated. In this article, the anatomy of the gracilis muscle, alternative neural sources (including the masseteric nerve), and technical aspects of the procedure are discussed. The literature regarding outcomes and complications is reviewed.
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