Classification and treatment of facial tissue atrophy in Parry-Romberg disease

Background: This report aims to show procedures that the senior author has used for the rehabilitation of facial deformities in Parry-Romberg disease since 1983. The authors also report the classification they use to plan the most appropriate surgical procedure for these patients. Methods: For this study, 95 patients (67 females and 28 males) with different types of facial tissue depression were classified according to the depth of the defect so adequate treatment could be planned. The cases were classified into four types. For types 1 and 2, only fat grafts were used, whereas for types 3 and 4, a combined procedure was used according to the case using cartilage and bone grafts, free dermis-fat grafts, and galeal flaps. Results: The results were successful, with few or no complications. Objective examinations showed excellent aesthetic improvement, with obvious deformity alleviated and the emotional status of the patients improved. Conclusions: The authors' practice frequently sees cases of Parry-Romberg disease, which has allowed them to gain significant experience in this field. For depression types 1 and 2, they recommend only fat infiltration, and for types 3 and 4, they favor combined treatment with lipoinjection, galeal flaps, free dermis-fat grafts, and bone and cartilage grafts. Occasionally, in areas of soft tissue with fibrosis, the authors infiltrated around 4 ml of fragmented fascia grafts instead of fat grafts.