ABSTRACT
This chapter focuses on the most common neuromuscular transfer in facial reanimation, the free transfer of subunits of the gracilis muscle for reanimation of oral commissure movement. The commissure and the nasolabial crease are marked on both sides with a waterproof pen on the immediate preoperative day. The difference between the actual and the planned position of the commissure at rest is registered on the paralyzed side with a ruler. The extent of movement of the commissure during smile on the non-paralyzed side is also measured directly using the ruler and the direction of movement is marked on the skin with an arrow. The facial skin on the paralyzed side is elevated from the pre-auricular incision, which is extended to the submandibular area. Subcutaneous dissection is carried on to the lower border of the mandible where the facial vessels are identified and exposed to be used as recipient vessels for the muscle graft.
