Innervated Free Groin Flap

not to speak or chew too much to prevent needle migration, which might be caused by facial muscle contraction. Therefore, when we performed the removal operation, the embedded needle was located 2 cm away from the opening (Fig. 4). In this case, the embedded foreign body had migrated. Acupuncture needles, fish bones, and broken dental needles are very hazardous foreign bodies that can migrate to other locations. Such migration can cause injury to critical structures or cause the foreign body to move to a deep layer where it may be difficult to remove. Almost all articles and case reports published thus far on this topic have reported the necessity of early surgical removal if the patient has exhibited any symptoms, irrespective of the size of the foreign object and its location with respect to a critical structure. Thus, early surgical removal of a sharp foreign object is important to minimize the risks that might be caused by the foreign body. There are many unlicensed individuals who perform acupuncture using unsafe materials, which can potentially lead to infections and can cause confusion with respect to the identification of the actual material of the embedded foreign object (Fig. 5). The embedded foreign body is likely to migrate, particularly in the facial area. Moreover, such migration may cause a critical injury. We are deeply concerned about the reality of the practice of acupuncture with inappropriate materials in certain cases. In light of the case presented here, we wish to direct the clinician’s attention to the risk of migration of an unsafe foreign object used in acupuncture and the need for an urgent removal operation, particularly when the object is embedded in the facial area.