Introduction: Facial paralysis presents a challenging problem with significant impact on quality of life, often resulting in severe and debilitating disability. A wide range of static and dynamic reconstructive techniques have been described to try to restore function. We describe our experience with reconstruction using innervated free flaps Aim: Review trends and outcomes in patients undergoing innervated free flap reconstruction of facial nerve palsy and tissue defect Methods: This is a retrospective case series of patients undergoing facial reanimation between 2022 to 2025 at the Royal Brisbane and Womens Hospital. All patient with facial nerve sacrificing procedure were identified and those who had innervated free flap reconstruction were identified Results: We identified 76 patients who had facial nerve sacrificing procedures between 2022 and 2025. 4 (5%) underwent innervated chimeric anterolateral thigh (ALT) flaps. This was most commonly augmented by other reconstructive procedures in the same operation. We describe our technique for utilizing the vastus muscle and nerve to vastus for dynamic facial animation. We discuss our outcomes, challenges and how we overcame these challenges Conclusions: Innervated chimeric ALT is a reasonable reconstructive option for dynamic facial reanimation.