LAUSR

Free gracillis muscle transfer is preferred mostly for facial reanimation (Zuker, 2015). Transferring the whole segment of gracillis muscle causes thick mass under the face skin and unaesthetically appearance deterioration when muscle was contracted after re-innervation period. Furthermore, anterior third of the muscle was transplanted to provide thin segment used in the face skin. The branches of obturator nerve and flap vessels are to take part in this muscle segment. Harvesting of flap from main segment may result in ropy edges of muscle segment because detached muscle fibrils contract independently. Ropy muscle edges may tear by stitches during flap insertion between the corner of the mouth and front of the ear. Providing proficient smile needs effective muscle contraction which depends on the fact that the transferred muscle length is to be equal to the distance between the front of the ear and the corner of the mouth. This tearing causes difficulty in the arrangement of muscle lengthening between the front of ear and oral commissure. Linear cutter stapler (Ethicon Endo-SurgeryTM Linear Cutters) may be used to harvest flap from main muscle body to have clean-cut border. This staples are usually used in abdominal, pediatric, and thoracic surgeries. Generally, the stapler is used for the resection and transection of organs or tissues. The linear cutting stapler is loaded with two double staggered rows of titanium staples and simultaneously cuts and divides tissues between the double rows. A sharp knife is built into the stapler body. The stapler can be easily operated by complete squeeze of the handles followed by shifting the side knob back and forth (http://www. medicalstapler.com/Linear-cutter-stapler.html). The stitches are knotted with 5 cm intervals to mark the muscle length on the anterior side and then two linear cutting staples are squeezed on proximal and distal edges of anterior third in gracillis muscle (Figure 1A). Two muscle edges are cut and harvested. Rows of titanium staples provide linear muscle edges to avoid ropy edges (Figure 1B). This metallic staples strongly anchor to knots between muscle and inserting area. Furthermore, this