Facial palsy is a disfiguring disease, often caused by inflammation, trauma, etc. The main manifestations are crooked mouth, incomplete eyelid closure, dull facial expression, speech inconvenience, and food retention in the affected side of the mouth, resulting in an ugly face. It brings great difficulties to patients’ life, work and social life, and makes patients lose confidence and courage to participate in social life, and even suffer from pain. In the early stage of facial palsy, neurotrophic drugs, facial nerve decompression, Chinese acupuncture and physiotherapy can be applied, but if the facial palsy lasts for more than 2 years and the function of facial expression muscle still has not recovered significantly, it is clinically called “advanced facial palsy” or “old facial palsy”. These patients can only be treated by plastic surgery to repair the deformity of their facial expression. In the past, the application of simple suspension method can correct the skewed state of the face at rest, but when the face moves, the mouth and eyes reappear, and a symmetrical smile cannot be formed. In recent years, we have applied denervated small muscle free grafts to treat facial palsy, which can restore 20% to 30% of the main facial power and can form a light smile. The current treatment is based on the application of nerve free graft, anastomosis with the contralateral normal facial nerve, application of thin femoral muscle, pectoralis minor muscle, and latissimus dorsi muscle, etc., carrying the vascular nerve of the muscle for anastomosis vascular and nerve grafting to reconstruct the main facial power, which can restore 80% of the patient’s facial power to the corners of the mouth and facial side power, and can form a more symmetrical smile with the contralateral side. The surgery needs to be performed in two stages. Phase I: free nerve grafting is performed and anastomosis is made with the normal lateral nerve buccal branch. After six months, the second stage of surgery is performed to anastomose the muscle graft of the vascular nerve and anastomose it with the branch of the normal lateral nerve. After the surgery is completed, facial power is gradually developed and 80% of muscle strength is restored after one year. The first stage of surgery requires approximately 7 days of hospitalization and the second stage requires approximately 7 to 10 days of hospitalization.