J Reconstr Microsurg 2005; 21(1): 15-19
DOI: 10.1055/s-2005-862774
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Microsurgical Dermal-Fat Retransfer for Progressive Hemifacial Atrophy

Hiroki Yano1 , Katsumi Tanaka1 , Ryuichi Murakami1 , 2 , Syogo Kaji1 , 3 , Akiyoshi Hirano1
  • 1Departments of Plastic and Reconstructive Surgery, Nagasaki University School of Medicine, Nagasaki, Japan
  • 2Departments of Plastic and Reconstructive Surgery, Yamaguchi Prefectural Central Hospital, Houfu, Japan
  • 3Departments of Plastic and Reconstructive Surgery, Matsue Red Cross Hospital, Matsue, Japan
Further Information

Publication History

Publication Date:
26 January 2005 (online)

ABSTRACT

Although the etiology of progressive hemifacial atrophy, Romberg's disease, is still unknown, it typically manifests during emotionally salient times, such as the period before the age of 20 years. It involves not only the subcutaneous tissue and skin but also the muscles and osteocartilaginous framework later. Treatment for the atrophy is, in general, recommended after progression of the disease ceases; otherwise, many augmentations will be required after re-atrophy. However, it has recently been reported that well-vascularized tissue might maintain its volume even in the progressive stage, and that progression might be interrupted by vascularized tissue transplantation. The authors report a case reconstructed with free vascularized dermal-fat re-transfer 13 years after a first reconstruction with free-flap transfer, because the primarily over-corrected region had gradually atrophied and the patient desired further treatment. Even though disease progression could not be completely controlled in this case, free vascularized tissue transfer should be considered for mentally fragile young patients, because the free flap is the best among the procedures for Romberg's disease for maintaining volume.

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Hiroki YanoM.D. 

Department of Plastic and Reconstructive Surgery, Nagasaki University School of Medicine

1-7-1 Sakamoto, Nagasaki 852-8102, Japan