Purpose: Smile and eyelid reanimation are generally emphasized in facial reanimation, but the loss of cheek tone provided by the buccinator muscle is not adequately addressed. The use of free gracilis muscle flap for facial reanimation has become widespread since it was used in head and neck reconstruction by Harii et al. The effect of free gracilis muscle transfer on drooling is not clearly defined in the literature. In our study, we aimed to evaluate the effect of free gracilis muscle transfer on drooling in patients with facial paralysis (FP) by using Blasco index. Smile function was overemphasized in the literature, but drooling was not evaluated. What happens to drooling after free functional muscle transfer was not clear, so this study was designed to evaluate improvement in drooling.Patients and Methods: Drooling and smile were evaluated in 11 patients (4 male, 7 female) who underwent facial reanimation with a free functional gracilis muscle transfer (FFGMT), in long-standing FP. The mean age was 39.9 years (range 22-56 years). Etiology was idiopathic in two patients, trauma in five patients, and intracranial tumor in four patients. Photographs and video recordings were taken preoperatively and at the first year postoperatively. The muscle was stitched to the upper lip, corner of the mouth, lower lip and the preauricular region. Masseteric nerve was preferred as donor nerve. Smile restoration was evaluated according to the five-stage classification defined by Terzis and Noah.Results: Flap dimensions differed from 12 cm 5 cm to 15 cm 6 cm. Oral intake was stopped for 5 days, and speaking was restricted postoperatively. Patients exercised for about 1 h starting from the postoperative third month. Patients were followed up for an average of 26.5 (14-48) months postoperatively. Postop courses were uneventful, and we did not observe any complications in these patients. Preoperative Blasco index score was 3 in 6 patients, 2 in 5 patients and the mean scores were 2.54 ± 0.52. Patients were followed for 1 year. No drooling was observed in the postoperative first year. The Blasco index score was 0 for all patients. The decrease in postoperative scores was found to be statistically significant (p < .01).Smile restoration was evaluated according to the five-stage classification defined by Terzis and Noah for facial reanimation after muscle transfer. Excellent results (grade

Popliteal artery occlusion is a rare vascular complication after blunt knee trauma and may lead to limb loss if diagnosis is delayed. Development of collateral pathways may misguide the surgeon in planning surgeries for defect reconstruction. We report a case of a patient with popliteal artery occlusion resulting from dislocation of knee after fall from height, which developed a defect anteromedial to ankle following orthopedic surgery. After reconstruction with a free flap, ischemia was observed in foot and arteriography confirmed the occlusion of popliteal artery with well-developed collateral arteries. The patient underwent femoro-popliteal bypass surgery for limb salvation. At the end of the recovery time, the defect was reconstructed with cross leg free flap.