Aesthetic Plastic Surgery

, Volume 33, Issue 1, pp 22–27 | Cite as

Use of Cell Fat Mixed with Platelet Gel in Progressive Hemifacial Atrophy

  • V. Cervelli
  • P. Gentile
Original Article


Progressive hemifacial atrophy, also known as Parry-Romberg syndrome, is an uncommon degenerative and poorly understood condition. It is characterized by a slow and progressive atrophy affecting one side of the face. The incidence and cause of this alteration are unknown, and the pathogenesis of the syndrome is not clear. Some authors attribute the atrophy of the subcutaneous system to an alteration of the sympathetic system. Others attribute it to an alteration of the nervous system at the encephalic level or to an interstitial neuritis of the trigeminal nerve. The most common complications that appear in association with this disorder are trigeminal neuritis, facial disorders, and epilepsy. The latter is the most frequent complication of the central nervous system. Characteristically, the atrophy progresses slowly for several years and soon becomes stable. After stabilization of the disease, plastic surgery of autogenous fat grafts can be performed. This study aimed through the presentation of clinical cases to suggest a therapeutic plan comprised of two sequential treatments: aquisition of platelet gel from a small volume of blood (9 ml) followed by the Coleman technique for reconstructing the three-dimensional projection of the face contour, restoring the superficial density of the facial tissues. The results obtained prove the efficacy of these two treatments combined, and the satisfaction of the patient confirms the quality of the results.


Platelet gel 


  1. 1.
    Chajchir A, Benzaquen I (1990) Fat injection. Aesth Plast Surg 14:127CrossRefGoogle Scholar
  2. 2.
    Mustoe TA, Cutler NR, Allman RM et al (1994) A phase II study to evaluate recombinant platelet-derived growth factor-BB in the treatment of stage 3 and 4 pressure ulcers. Arch Surg 129:213PubMedGoogle Scholar
  3. 3.
    Pinheiro TP, Silva CC, Silveira CS, Botelho PC, Pinheiro MG, Pinheiro Jde J (2006) Progressive hemifacial atrophy–case report. Med Oral Patol Oral Cir Bucal 11(2):E112–E114. Review.Google Scholar
  4. 4.
    Coiffman F (1985) Texto de Cirugía Plástica Reconstructiva y Estética. Editorial Científico-Técnica, La HabanaGoogle Scholar
  5. 5.
    Chajchir A, Benzaquen I (1986) Liposuction fat graf in face wrinkles and hemifacial atrophy. Aesth Plast Surg 10:115CrossRefGoogle Scholar
  6. 6.
    Miller MT, Sloane H, Goldberg MF, Grisolano J, Frenkel M, Mafee MF (1987) Progressive hemifacial atrophy (Parry Romberg disease). J Pediatr Oftamol Strabismus 24:27–36Google Scholar
  7. 7.
    Chajchir A, Benzaquen I (1991) Fat injection Long-term follow-up. Aesth Plast Surg 20:291–296CrossRefGoogle Scholar
  8. 8.
    Coleman SR (1997) Facial recontouring with lipostructure. Clin Plast Surg 24:347PubMedGoogle Scholar
  9. 9.
    Coleman SR (1995) Long-term survival of fat transplants: controlled demonstrations. Aesth Plast Surg 19:421–425CrossRefGoogle Scholar
  10. 10.
    Coleman SR (2008) Lower lid deformity secondary to autogenous fat transfer: a cautionary tale. Aesthetic Plast Surg 32(3):415–417Google Scholar
  11. 11.
    Chajchir A, Benzaquen I, Moretti E (1993) Comparative experimental study of autologous adipose tissue processed by different techniques. Aesth Plast Surg 17:113–115CrossRefGoogle Scholar
  12. 12.
    Finesilver B, Rosow HN (1938) Total hemiatrophy. JAMA 5:366–368Google Scholar
  13. 13.
    Mazzeo N, Fisher JG, Mayer MH, Mathieu GP, Mcade FGG (1995) Progressive hemifacial atrophy (Parry Romberg syndrome). Oral Surg Oral Med Oral Pathol Oral Radiol Endod 79:30–35PubMedCrossRefGoogle Scholar
  14. 14.
    Moore MH, Wong KS, Proudman TW, David DJ (1993) Progressive hemifacial atrophy (Romberg’s disease): Skeletal involvement and treatment. Br J Plast Surg 46:39–44PubMedCrossRefGoogle Scholar
  15. 15.
    Pensler JM, Murphy GF, Muliken JB (1990) Clinical and ultrastructural studies of Romberg’s hemifacial atrophy. Plast Reconstr Surg 85:669–676PubMedCrossRefGoogle Scholar
  16. 16.
    Zafarulla MY (1985) Progressive hemifacial atrophy: a case report. Br J Ophthalmol 69:545–547PubMedCrossRefGoogle Scholar
  17. 17.
    Guerrerosantos J (1996) Authologous fat grafting for body contouring. Clin Plast Surg 23:619–631PubMedGoogle Scholar
  18. 18.
    Chajchir A, Benzaquen I (1989) Fat grafting injection for soft tissue augmentation. Plast Reconstr Surg 84:921–934 discussion 935PubMedGoogle Scholar
  19. 19.
    Taub PJ (2000) Plastic surgical perspectives on vascular endothelial growth factor as gene therapy for angiogenesis. Plast Reconstr Surg 105:1034–1042PubMedCrossRefGoogle Scholar
  20. 20.
    Chajchir A (2004) Factores de crecimiento en cirugía plástica: comunicación preliminar. Revista Argentina de Cirugía Plást 10:114–117Google Scholar
  21. 21.
    Chajchir, Abel y cols (2005) Growth factors in plastic surgery. Plast Reconstr Surg 29:295–299Google Scholar
  22. 22.
    Lexer E (1914) Free fat grafting. IV Congr. Soc. Int. Cir., NY, p 441Google Scholar
  23. 23.
    Peer L (1950) Loss of weight and volume in human fat grafts. Plast Reconstr Surg 5:17–30CrossRefGoogle Scholar
  24. 24.
    Viñas J et al (1973) La región pubiana como dadora de injertos de grasa. Prensa Méd Argentina 60:942Google Scholar
  25. 25.
    Illouz YG (1986) The fat cell graf: a new technique to fill depressions. Plast Reconstr Surg 78:122PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2008

Authors and Affiliations

  1. 1.Department of Plastic and Reconstructive Surgery “Policlinico Casilino”University “Tor Vergata”RomeItaly
  2. 2.RomeItaly

Personalised recommendations