Muscle flap transfer in facial reanimation moves a local or free muscle to restore dynamic movement such as smiling or eyelid closure. The flap is reinnervated using nearby or cross‑facial nerves.
Types
Local transposition flaps, like temporalis muscle transfer, redirect existing muscle to the corner of the mouth or eyelids. Free functional muscle transfer, often using gracilis muscle from the thigh, is microsurgically connected to vessels and nerves in the face.
- Provides active movement when native facial muscles are no longer viable
- Requires microsurgical expertise and careful planning
- Temporalis transfer can also assist eyelid closure in some techniques
- Rehabilitation trains patients to use new muscle movements for expressions
Results
Muscle transfers can yield spontaneous or volitional smiles and improved symmetry, though movement patterns may differ from normal. Multiple stages and refinements are common.
- Donor site morbidity, such as thigh weakness, is usually limited
- Complications include flap failure, asymmetry, or need for debulking
- Long-term exercises and follow‑up support functional integration
- Combined with static and eyelid procedures, they form part of comprehensive reanimation
