Alloplastic implants for skeletal augmentation in Parry-Romberg syndrome: A systematic review

Parry-Romberg syndrome (PRS) is a rare disorder characterized by progressive hemifacial atrophy affecting soft tissue and, in severe cases, bone. Reconstructive surgery is commonly used to manage PRS-related facial deformities. This systematic review assesses the current literature on alloplastic implants for facial reconstruction in PRS. Following PRISMA guidelines, we conducted a systematic review across MEDLINE, Google Scholar, and Cochrane databases, including English-language studies on PRS managed with alloplastic implants. Eleven studies, including 74 PRS patients (age range 12-45, mean 22.3), were analyzed. Most patients received off-the-shelf implants, with a single case using a 3D-modeled titanium implant. Implants, often adjunctive to free flap-based soft tissue augmentation, fat grafting, or orthognathic surgery, were typically placed in the malar, mandibular, or mental regions, with porous polyethylene (Medpor) being the most frequently used material. Complications were minimal, with infections (n = 2) and one aesthetic issue requiring removal (follow-up range: six months to 13 years; mean 39 months). Alloplastic implants effectively restore facial symmetry in PRS, commonly alongside soft tissue reconstruction. Future studies on custom-designed implants are warranted to enhance treatment consistency and long-term outcomes.