title: Classification and treatment of facial tissue atrophy in Parry-Romberg disease.
abstract: BACKGROUND
  This report aims to show procedures that the senior author has used for the rehabilitation of facial deformities in Parry-Romberg disease since 1983. The authors also report the classification they use to plan the most appropriate surgical procedure for these patients.
  
  
  METHODS
  For this study, 95 patients (67 females and 28 males) with different types of facial tissue depression were classified according to the depth of the defect so adequate treatment could be planned. The cases were classified into four types. For types 1 and 2, only fat grafts were used, whereas for types 3 and 4, a combined procedure was used according to the case using cartilage and bone grafts, free dermis-fat grafts, and galeal flaps.
  
  
  RESULTS
  The results were successful, with few or no complications. Objective examinations showed excellent aesthetic improvement, with obvious deformity alleviated and the emotional status of the patients improved.
  
  
  CONCLUSIONS
  The authors' practice frequently sees cases of Parry-Romberg disease, which has allowed them to gain significant experience in this field. For depression types 1 and 2, they recommend only fat infiltration, and for types 3 and 4, they favor combined treatment with lipoinjection, galeal flaps, free dermis-fat grafts, and bone and cartilage grafts. Occasionally, in areas of soft tissue with fibrosis, the authors infiltrated around 4 ml of fragmented fascia grafts instead of fat grafts.
authors: Jalisco Plastic and Reconstructive Institute, Public Health System, Medical School, University of Guadalajara, Avenida Federalismo Norte #2022, Guadalajara, Jalisco, México. guerrerosantos@megared.net.mx
authors: José
authors: J
authors: Guerrerosantos
authors: Fernando
authors: F
authors: Guerrerosantos
authors: Jessica
authors: J
authors: Orozco
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D000328:Adult; D005150:Facial Hemiatrophy / Q000145:classification / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D019737:Transplants; D016896:Treatment Outcome