J Reconstr Microsurg 2009; 25(1): 063-067
DOI: 10.1055/s-0028-1104560
© Thieme Medical Publishers

The Semi-Open Approach to the Gracilis Muscle Flap: Aesthetic Refinements in Gracilis Muscle Harvest

Arash Momeni1 , Holger Bannasch2
  • 1Department of Surgery, Stanford University Medical Center, Stanford, California
  • 2Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Freiburg, Germany
Further Information

Publication History

Publication Date:
01 December 2008 (online)


The gracilis muscle flap is certainly among the most versatile sources of vascularized tissue available for microsurgical reconstruction. However, the aesthetic appearance of the resultant scar has frequently been a source of dissatisfaction. Various minimal invasive techniques have been proposed, all of which aim to reduce scar formation. Drawbacks of endoscopic techniques, however, include a steep learning curve as well the need for special technical equipment. A semi-open approach without endoscopic assistance is presented, characterized by a short transverse incision in the groin area without a counterincision distally. This technique was performed in six patients (mean age, 48.8 years). Mean incision length was 8.8 cm, and average muscle harvesting time was 49 minutes. We suggest the semi-open approach to the gracilis muscle flap because it does not require special instruments and training and is characterized by easy performance and a short incision in the inconspicuous groin area with resultant better cosmesis.


Arash Momeni, M.D. 

Department of Surgery, Stanford University Medical Center

300 Pasteur Drive, Stanford, CA 94305

Email: arash.momeni@googlemail.com