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Page 16 of 22 Vakhshori et al. Plast Aesthet Res 2023;10:36 https://dx.doi.org/10.20517/2347-9264.2022.78

Figure 9. Planned incision for transfer of the gracilis muscle to the anterior arm.

Figure 10. Dissection of the donor artery in the anterior arm for transfer of the gracilis muscle.

loss . Silva et al. compared gracilis muscle transfers innervated by the spinal accessory nerve, intercostal
[49]
nerves, median nerve fascicles, ulnar nerve fascicles, or phrenic nerves. Success rates were similar between
[53]
groups, with an overall success rate of 65% achieving at least grade M3 strength . Nicoson et al. performed
gracilis transfers with spinal accessory nerves, intercostal nerves (with or without rectus abdominis nerves),
medial pectoral nerves, thoracodorsal nerves, and fascicle of ulnar nerves. They found a mean recovery
strength of M4.5 for medial pectoral, M4 for thoracodorsal, M3.3 for intercostal, M3 for spinal accessory,
[67]
and M2 for ulnar nerve fascicles, but had limited numbers . Cho et al. compared neurotization of gracilis
transfers by spinal accessory nerves or motor fascicles of the ulnar nerve, with 83% of those with spinal