ABSTRACT
The gracilis flap is most frequently used in free neuromuscular tissue transfer for facial reanimation after longstanding facial paralysis. The low profile of the muscle and the organization in small innervated segments make this flap particularly suitable for the reconstruction of mimic muscles. The muscle is extensively used as a pedicled flap for reconstructive procedures in the perineal area. In an upright position, this would delineate the anterior margin of the gracilis muscle. In a horizontal position in relaxation, the muscle drops down and the anterior margin is located approximately 15 mm posterior to the straight line, where it should be marked with an additional line. The vascular pedicle runs in the intermuscular septum between the adductor longus and the adductor magnus before entering the gracilis muscle. The anterior half of the muscle belly is commonly innervated by one fascicle; the posterior half is supplied by the remaining ones with some overlap in the midline.
