title: Treatment of severe hemifacial atrophy with dorsal thoracic adipofascial free flap and concurrent lipoinjection.
abstract: BACKGROUND
  Parry-Romberg syndrome is an infrequent, acquired disorder characterized by progressive facial atrophy of the skin and soft tissue of the face and, in some cases, results in atrophy of muscles, cartilage, and the underlying bony structures. We investigated dorsal thoracic adipofascial free flap and concurrent lipoinjection as a reconstructive option for Parry-Romberg syndrome.
  
  
  METHODS
  Thirteen patients with hemifacial atrophy caused by Parry-Romberg syndrome underwent surgical correction after their deformitiesreached a stable stage. All patients were classified as having severe atrophy; they had either atrophy of the skin and subcutaneous tissues observable in all 3 sensory branches of the trigeminal nerve or bone involvement. In all cases, we applied dorsal thoracic adipofascial free flap and concurrent lipoinjection followed by secondary revision with debulking or lipoinjection.
  
  
  RESULTS
  The adipofascial flaps survived after the initial operation in all 13 patients. After the second-stage operation, 11 of 13 patients had achieved a natural appearance without any sagging or insufficient filling in the upper face.
  
  
  CONCLUSIONS
  For patients with severe hemifacial atrophy with little or no bone involvement, dorsal thoracic adipofascial free flap and concurrent lipoinjection was a feasible and reliable reconstructive option.
authors.affiliation: From the *Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China; †Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; ‡Department of Plastic and Reconstructive Surgery, PLA General Hospital, Beijing; and §Department of Plastic Surgery, 260th Hospital of PLA, Shijiazhuang, People's Republic of China.
authors.forename: Baoqiang
authors.initials: B
authors.lastname: Song
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.forename: Yan
authors.initials: Y
authors.lastname: Han
authors.forename: Yalan
authors.initials: Y
authors.lastname: Hu
authors.forename: Juan
authors.initials: J
authors.lastname: Zhang
authors.forename: Chaohua
authors.initials: C
authors.lastname: Liu
authors.forename: Dongyue
authors.initials: D
authors.lastname: Hao
authors.forename: Shuzhong
authors.initials: S
authors.lastname: Guo
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D004954:Esthetics; D005145:Face / Q000601:surgery; D005150:Facial Hemiatrophy / Q000601:surgery*; D005205:Fascia / Q000637:transplantation*; D005260:Female; D058752:Free Tissue Flaps / Q000637:transplantation*; D006085:Graft Survival; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods; D060053:Transplant Donor Site / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult