The gracilis muscle transplant procedure has the ability to restore moving, functional muscle to the face. This is particularly useful in cases of long-standing facial paralysis, also called chronic facial paralysis. The procedure involves harvest of muscle from the inner thigh through a surgical incision. The gracilis muscle is detached, including its blood vessels and nerve. The muscle is then transplanted to the paralyzed side of the face and connected to a nerve and blood vessel.
Once the gracilis muscle is transplanted to the paralyzed side of the face, it must be connected to a new nerve so that it may move the paralyzed side of the face. The gracilis muscle may be connected to the nerve that is normally used for biting, to a cross-facial nerve graft or to both simultaneously. These options are decided based on a discussion between the surgeon the patient. In general, the gracilis may be performed in a single surgery, or it can be performed in two surgeries that are separated by approximately nine to 12 months. Patients usually stay in the hospital for approximately five days after this surgery.