{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T22:47:14Z","timestamp":1784242034498,"version":"3.55.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T00:00:00Z","timestamp":1620604800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Facial Plastic Surgery &amp; Aesthetic Medicine"],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Importance:<\/jats:title>\n                    <jats:p>The free functional gracilis flap (FFGF) is a versatile procedure in reanimating the paralyzed face, yet its application in seniors is limited by perceptions of morbidity and inefficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The study objective was to compare the morbidity and effectiveness of FFGF reanimation among senior and younger patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Setting, and Participants:<\/jats:title>\n                    <jats:p>A retrospective chart review was performed on 20 consecutive patients aged 60 years and above (seniors) and 35 patients aged 40 years and below (juniors) who underwent FFGF for facial reanimation. Among this group, 16 senior and 22 junior patients with available long-term follow-up data were analyzed for functional outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures:<\/jats:title>\n                    <jats:p>The length of postoperative stay and postoperative complications were compared with assess immediate results. A second analysis for functional outcomes was assessed by resting and smile facial asymmetry index (FAI), as well as maxillary dental display to compare facial tone and lip excursion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The average age of seniors was 67\u2009\u00b1\u20095 years and that of juniors was 27\u2009\u00b1\u200910 years. Mean lengths of postoperative stay were 4\u2009\u00b1\u20092 versus 3\u2009\u00b1\u20091 days in seniors versus Juniors, respectively (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.16). There were no intraoperative complications and postoperative complications in one (5%) senior and four (11%) juniors (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.64). There was functional muscle recovery in all cases, with more pronounced correction of both resting (\u03943.0\u2009mm vs. \u03942.4\u2009mm,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.66) and dynamic (\u03945.2\u2009mm vs. \u03944.2\u2009mm,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.37) FAI in seniors than in juniors. Among patients who underwent a multivector FGFF, there was an additional three versus one visualized maxillary teeth (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.03) in seniors versus juniors, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance:<\/jats:title>\n                    <jats:p>The FFGF is effective for facial reanimation among seniors and can be performed with minimal morbidity. Age alone should not preclude the application of the FFGF in seniors with a preference for more dynamic options.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/fpsam.2020.0292","type":"journal-article","created":{"date-parts":[[2020,8,6]],"date-time":"2020-08-06T14:42:01Z","timestamp":1596724921000},"page":"180-186","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Free Functional Gracilis Flaps for Facial Reanimation in Elderly Patients"],"prefix":"10.1177","volume":"23","author":[{"given":"Andrew H.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui Han","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Johns Hopkins 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USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kofi","family":"Boahene","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, 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