Evaluating Autologous Lipofilling for Parry-Romberg Syndrome–Associated Defects: A Systematic Literature Review and Case Report

Abstract

Fat grafting for correction of PRS-associated soft-tissue defects is receiving heightened acceptance for its ability to restore natural facial contours. While additional fat-grafting procedures may be required with increased disease severity, autologous fat grafting may be a beneficial option as a sole modality to correct PRS-associated soft-tissue atrophy.

Receptor for hyaluronan mediated motility (RHAMM/HMMR) is a novel target for promoting subcutaneous adipogenesis

“…Fat grafting using the widely accepted Coleman technique now provides solutions to difficult clinical problems. For example, fat grafting provides cosmetic rescue of localized pathological facial fat atrophy of HIV lipodystrophy patients[58], and in patients with Parry-Romberg syndrome[59, 60]. Fat grafting also results in improved skin quality of radiated, burned, or badly scarred tissues by reducing radiation-induced tissue damage such as inflammation, hyperpigmentation, and ulceration.…”

Bone Resorption of the Jaws and Occlusal Disturbances in Parry-Romberg Syndrome

“…A wide range of treatments exists in the re-establishment of normal function and aesthetics: silicone implants, bovine collagen implants, hyaluronic acid injections, autogenous fat grafts, cartilage grafts, and others. The aim of these treatments is primarily the reposition of fat tissue lost due to the atrophy [9], [10], [11]. Regarding the orthodontic treatment during the atrophy, Grippaudo et al established that it will limit the osseous deformity stimulating the mandibular growth, thus optimizing the symmetrical function of the mandible since the craniofacial development is mainly determined by muscular function [12].…”

Applications of Fat Grafting in Pediatric Patients

“…1). 20 Application of fat grafting in Parry-Romberg syndrome is often tailored to the severity of disease. In patients with mild disease, smaller volumes of 1 to 3 mL can be injected into focal areas, such as the periorbital and glabellar regions, for effective facial contouring.…”

“…Patients with more severe phenotypes may require larger volumes up to 400 mL and multiple lipofilling treatments to achieve complete volume correction and facial symmetry. 20 Notably, the amount of fat graft used in the initial transfer may be limited due to decreased elasticity of the affected skin and its fixation to underlying structures. The first injection improves the quality of the tissue, making subsequent fat transfers more effective.…”

“…The first injection improves the quality of the tissue, making subsequent fat transfers more effective. 20,21 To facilitate more accurate surgical planning of volume correction and minimize potential for repeat grafting, volume replacement in Parry-Romberg syndrome is generally recommended after the soft tissue atrophy has stabilized. 3 As it may take several years for the disease to stabilize, patients with Parry-Romberg syndrome typically undergo lipofilling as adults.…”