How to Treat Congenital Facial Paralysis with a Gracilis Muscle Transplant

How to Treat Congenital Facial Paralysis with a Gracilis Muscle Transplant

For people who have lived with long-term or congenital facial paralysis, it can be easy to feel despair because they think there’s nothing that can help them. However, if they are dealing with unilateral or bilateral facial paralysis, they may be good candidates for a Gracilis flap procedure, which can help reanimate the face.

The procedure gets its name from the Gracilis muscle, which is used to create natural facial movement. The Gracilis muscle starts at the pubic bone and runs down the inner thigh. It’s a thin and flat muscle, which makes it ideal for transplantation. Also helpful: the muscle can be transplanted to the face along with its artery and vein for blood supply, as well as its nerve. The patient doesn’t suffer any loss of motion in the leg with the removal of the Gracilis muscle, as other muscles can take over.

Before the Gracilis muscle can be transplanted, however, the first stage of the procedure must be done: a cross facial nerve graft.  The sural nerve from the lower leg is harvested and attached to a nerve on the normal side of the face, and this will allow for the graft to adapt to facial motion and function. Once the nerve graft is regenerated—usually after about eight months to a year—the Gracilis muscle can then be transplanted.

A Gracilis free flap procedure is performed with cutting-edge microsurgical techniques. A portion of the Gracilis muscle, its nerves and blood supply are taken from the patient’s leg and the Gracilis muscle is then transplanted into the face and attached near the ear and the corner of the mouth and to the cross facial nerve graft; the graft will trigger movement in the transplanted Gracilis muscle. The muscle’s artery and vein are also surgically attached to the local blood supply in the face. The patient’s resulting smile looks natural and is spontaneous.

As with most surgeries of this nature, there is some recovery time involved to recuperate from the procedure and to ensure the nerves and blood supply have successfully transplanted and are functioning properly. Also, care should be taken to watch the site where the donor nerve was removed to make sure it heals properly.

While there is recovery time involved, the results are well worth it. The difference in a patient’s smile can be dramatic. Facial reanimation through a Gracilis flap procedure can give patients movement and expressions that they haven’t had for years. For patients who have grown accustomed to their facial paralysis, the ability to get their smile back is nothing short of life-changing.

Of course, with an intricate procedure such as this and a recovery period that requires close attention to ensure proper healing, patients will want to seek out only the top surgeons in order to get the amazing results they desire. Dr. Babak Azizzadeh and his team at the Facial Paralysis Institute are experts in a wide variety of treatments for people suffering from facial paralysis, including the Gracilis transplant surgery. The team is highly skilled and takes a multidisciplinary approach to each case to try and achieve the best possible outcome. At the Facial Paralysis Institute, the mission is to restore self-confidence and improve the quality of life for each patient. To inquire about a consultation for a Gracilis muscle transplant, or any other treatment, contact us today.