Combined treatments of facial contour deformities resulting from Parry-Romberg syndrome.

Parry-Romberg syndrome is characterized by a progressive hemifacial atrophy involving the skin, subcutaneous tissue, and underlying bone structures. The aim of plastic surgical treatment is to restore a harmonious and symmetrical appearance to facial deficits. The authors report that 17 patients with Parry-Romberg syndrome were treated with combined techniques in multiple stages. Revascularized free flaps, including 12 anteriolateral thigh adipofascial flaps and two latissimus dorsi flaps, were used for soft tissue augmentations in the first stage. Additional procedures, including dermis grafting, lipoinjection, placement of Medpor implant, and plastic techniques, such as genioplasty, liposuction revision, and others, were used for bone augmentations or corrections of minor deficits in the second or third stage. Generally, it took an average of 3.5 procedures to obtain satisfying results. Postoperative courses were smooth in 15 patients except for two hematoma complications in two cases. Transferred tissues had partial fat liquefying and subcutaneous indurations 6 months postoperatively in two cases. All patients received good or improved aesthetic outcomes. Combined treatments are needed to correct facial contour deformities resulting from Parry-Romberg syndrome.