"babysitter" procedure may be used.(Algorithm 1) During this operation both CFNGs and part of an undamaged donor nerve on the affected side are used. For example, the hypoglossal nerve or masseteric nerve on the affected side can be used as donor nerves. This donor nerve is then attached to the distal end of the paralysed facial nerve. A free muscle transplant is sometimes indicated after the "babysitter" procedure has been performed, depending on the continuity of the injured facial nerve. In other words, if there is contraction of the mimetic muscle during an electromyogram. After a denervation time of approximately more than 2 years, atrophy of the mimetic muscles is permanent. In these cases a free muscle transfer is always performed in combination with a CFNG. The procedure of choice for congenital facial paralysis is either CFNG or motor donors, both with a free muscle transfer. (Algorithm 2) Incomplete bilateral Moebius syndrome has the same clinical features as the Moebius syndrome, however some motor function is still apparent on one side of the face. This incomplete syndrome is reanimated with the use of the CFNG and free muscle transfer. The cross facial nerve graft comes from the side with some motor function of the facial nerve. However it first has to be investigated if the motor function of the nerve is strong enough to be separated. A free muscle transfer is always used on the paralysed side, as the muscle is a congenital atrophic muscle. Complete bilateral Moebius syndrome is treated with motor donor nerves on both sides. Optional motor donor nerves are: the masseteric nerve, accessory nerve or hypoglossal nerve. In rare cases when these nerves are also affected, cervical nerve branches can be used. The use of a free muscle transfer is again indicated. The nerve that initially innervated the free muscle transfer is then connected to the provided branches of the motor donor nerve. In Moebius-like syndrome the CFNG is performed, as the facial nerve on the affected side does not have a strong enough motor function. A free muscle transfer is also used, due to the atrophic muscle. Surgical procedures Based on the preference of the surgeon, the gracilis muscle, latissimus dorsi muscle, or pectoralis minor muscle are used as free neurovascular grafts. The gracilis muscle is mostly used free neurovascular muscle, because it has a reliable anatomy and is relatively simple to harvest. In addition,