Successful Treatment of Parry-Romberg Syndrome With Autologous Fat Grafting

Abstract

Parry first described the syndrome of progressive facial atrophy in 1825, followed by Romberg in 1846. The clinical hallmark of the syndrome is atrophy of the facial soft tissues, including fat and muscle as well as underlying bone. Clinicians have classically reserved treatment until the end of the disease process, after the "burn out" stage. Various treatment modalities have been attempted with differing results. In this study, we present a case of Parry-Romberg syndrome treated with autologous fat grafting. This case report reviews the history of the disease, examines the safety and clinical outcomes of fat grafting as a treatment modality, and challenges the classic timing of that treatment. Additionally, long-term follow-up with photos and histological analysis of specimens are included.

Fat Grafting for Facial Filling and Regeneration

“…19 Finally, fat grafting is extremely valuable in correcting congenital and acquired soft tissue defects of the face, including HIV-related lipoatrophy and Perry-Romberg syndrome, linear scleroderma, surgical defects, and scarring and traumatic loss of soft tissue, as well as underlying bony injuries. [20][21][22][23] Similar to the goals in the esthetic patient, fat grafting in the reconstructive realm aims to restore healthy, natural facial contours.…”

Evaluating Autologous Lipofilling for Parry-Romberg Syndrome–Associated Defects: A Systematic Literature Review and Case Report

“…Months Effective High aesthetic satisfaction Avelar et al (2010) 1 y Good Satisfied Castro-Govea et al (2012) 1 y Satisfactory Cervelli and Gentile (2009) 1-2 y Satisfied Chang et al (2013) 1 y Improved None Clauser et al (2010) Not specified Good Satisfied Cortese et al (2000) Not specified Very good Increased reabsorption in areas of high mobility Deshmukh et al (2012) Not specified Ersek et al (1998) 7 mo Symmetrical appearance Grimaldi et al (2008) Not specified Effective Satisfied Guerrerosantos et al (2007) 1-8 y Improved Satisfied Hu et al (2011) Not specified Improved Hunstad et al (2011) 14 y Successful Hypertrophy of transplanted fat with weight gain Kanchwala et al (2003) 3 y Excellent Koh et al (2012) 1.5 y Excessive volume loss with weight loss in one case Liu and Cohen (2010) 1 y Successful Longobardi et al (2011) 6 y Excellent Moscona et al (1989) 18 mo Satisfied Edema with injections, minimal reabsorption Onesti et al (2009) 1 y Good Satisfied Pagnoni et al (2012) 1 y Good Edema with injections, minimal reabsorption Palmero et al (2010) Not specified Fat necrosis Raposo-Amaral et al (2013) 1-4 y Satisfactory Roddi et al (1994) 3-18 mo Minimal reabsorption Saccomanno et al (1997) 2 y None Slack et al (2012) 5-28 y Improved symmetry Sterodimas et al (2009) 13 mo Improved aesthetics Satisfied Edema with injections Tiryaki et al (2011) 18 mo Satisfied Subcutaneous ecchymosis Tobin and Middleton (1989) 9 mo Improved aesthetics Satisfied None Xie et al (2007) 3 …”

A New Minimally Invasive Aesthetic Procedure for Correction of Frontal Coup de Sabre Deformity in Romberg’s Syndrome

“…Of the various options available for restoration of facial volume in PRS, the use of autologous fat graft has dramatically increased with advances in fat grafting techniques. Face is an ideal recipient site with rich blood supply which acts as an optimal scaffold, yielding a high percentage take of transplanted adipose cells [11]. An article by Mojallal et al [19] examined the effects of human fat transfer in mice from a clinical and histologic level.…”

“…The treatment is systematic and directed at reconstruction of the deficient tissue to improve the contour and symmetry of face. Described treatments include free tissue transfer, pedicled flaps, autologous tissue (fat, bone, cartilage) and biomaterials (silicone, alloderm, polyethylene) [11]. Among these techniques, fat grafting is the most commonly performed procedures, especially for mild to moderate asymmetry [7,[12][13][14][15][16].…”