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Updated: Mar 2, 2026
Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Dual chimeric innervated vastus lateralis free flap for single stage blink and midface reanimation
Lauren S H Chong1,2, Richard Tjahjono2, Timothy J Eviston1,2,3
1University of New South Wales, Faculty of Medicine, Sydney, New South Wales, 2052, Australia.
Background:
The immediate reconstruction of the face in the setting of radical parotidectomy for malignancy represents a particular challenge. We present a novel technique using 2 sections of the vastus lateralis muscle as a chimeric flap in combination with the anterolateral thigh (ALT) fasciocutaneous flap to achieve midface reanimation and eye closure after radical parotidectomy.
Methods:
The harvest technique in view of variations in chimeric muscle components, vascular pedicles, and neural coaptations is described herein.
Results:
On postoperative facial nerve examination, we observed encouraging results in middle-aged patients even in the context of radiotherapy.
Conclusion:
Although reanimation using the chimeric vastus lateralis free flap is yet to be objectively determined in a large series, our experience is that this flap adds the potential of dynamic midface movement and eye closure to our current reconstructive approach with excellent postoperative results in selected cases.
