Microsurgical dermal-fat retransfer for progressive hemifacial atrophy

Area of Science:

• Plastic Surgery
• Regenerative Medicine
• Dermatology

Background:

• Progressive hemifacial atrophy (Romberg's disease) is a rare condition causing facial disfigurement, typically starting before age 20.
• The condition affects skin, subcutaneous tissue, muscles, and bone, with unknown etiology.
• Traditional treatment is often delayed until disease progression stops, risking further atrophy and repeated interventions.

Purpose of the Study:

• To evaluate the efficacy of free vascularized dermal-fat re-transfer in managing progressive hemifacial atrophy.
• To assess the long-term volume maintenance in a case of Romberg's disease treated with vascularized tissue transplantation.
• To explore treatment options for young, mentally fragile patients experiencing progressive facial atrophy.

Main Methods:

• A case study involving a patient with Romberg's disease undergoing secondary reconstruction.
• Utilized free vascularized dermal-fat re-transfer 13 years after initial free-flap surgery.
• Monitored the outcome regarding volume maintenance and disease progression control.

Main Results:

• The secondary reconstruction with free vascularized dermal-fat re-transfer provided volume restoration.
• Complete control of disease progression was not achieved.
• The well-vascularized tissue demonstrated some capacity for volume maintenance during the progressive stage.

Conclusions:

• Free vascularized tissue transfer is a viable option for Romberg's disease, particularly for young patients concerned about appearance.
• This technique may help maintain tissue volume even during active disease progression.
• Further research is needed to optimize management strategies for progressive hemifacial atrophy.