title: Parry-Romberg reconstruction: beneficial results despite poorer fat take.
abstract: OBJECTIVE
  For the treatment of Parry-Romberg syndrome or progressive hemifacial atrophy, we studied the volume retention and skin changes after autologous fat grafts within diseased regions.
  
  
  BACKGROUND
  The long-term survival and volume retention of fat grafts used in soft tissue reconstruction of Parry-Romberg syndrome is still unknown, as are skin changes after fat grafting.
  
  
  METHODS
  Sex, age, severity of deformity, number of procedures, operative times, and augmentation volumes were recorded. Preoperative/postoperative 3-dimensional computed tomographic scans were also reviewed. A digital 3-dimensional photogrammetry system was used to determine "final fat take" and symmetry. Romberg fat grafting volumes were compared to nonaffected, cosmetic fat-grafted patients. For skin changes, a spectrophotometer was used to quantify percent improvement in melanin index. Physician and patient satisfaction surveys (5-point scale) were elicited, including overall outcome and skin color/texture.
  
  
  RESULTS
  The mean number of procedures correlated to the severity of deformity: mild, 1.8 procedures; moderate, 3.4; and severe, 5.2. With Romberg patients, fat grafting injected: per case, 48 mL; total, 188 mL; and final measured volume, 101 mL. Romberg patients had less "fat take" than nonaffected grafted patients (final take, 41% vs 81%). Skin color/texture showed 3-fold improvement after fat grafting procedures. The mean melanin index improvement seen in the diseased regions of Romberg patients after fat grafting was 42% (+3%). Skin color and texture improvement was also shown in patient surveys (preoperative = 2.4 + 0.06 to follow-up = 3.4 + 0.09) and physician (preoperatively = 2.1 + 0.1 to follow-up = 3.6 + 0.1).
  
  
  CONCLUSIONS
  Despite poorer fat graft take within the disease region of Romberg patients, fat grafting resulted in long-term improvement in hypoplasia and skin hyperpigmentation.
authors.affiliation: From the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
authors.forename: Ginger C
authors.initials: GC
authors.lastname: Slack
authors.forename: Christina J
authors.initials: CJ
authors.lastname: Tabit
authors.forename: Karam A
authors.initials: KA
authors.lastname: Allam
authors.forename: Henry K
authors.initials: HK
authors.lastname: Kawamoto
authors.forename: James P
authors.initials: JP
authors.lastname: Bradley
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D005150:Facial Hemiatrophy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods; D016896:Treatment Outcome