Parry Romberg Syndrome Before & After Photos

This patient is seen shortly after his first round of fat grafting.

Parry Romberg syndrome (aka progressive hemifacial atrophy) is a condition where usually half of a person’s face begins to waste away.

This may involve skin and fat only, or can also affect the muscle, bone, and cause pain.

Sometimes only a part of the face is involved, like the forehead or the cheeks. Other times, migraine headaches, changes in pigment, or shrinking of half of the tongue is seen.

Most commonly Parry Romberg syndrome begins at puberty. We have seen patients of all ages affected, though, often after a viral infection or trauma.

Treatment most commonly involves fat grafting. This involves liposuction of fat from an unaffected area like the flank, and transferring the fat in small amounts to the affected area.

Typically anywhere from 1/3rd to 2/3rds of the transferred fat takes hold and persists.

Treatment may involve multiple rounds of grafting to achieve reasonable symmetry, and sometimes is repeated over the years as facial fat and the transferred fat may age differently.

Other options for treatment are available as well, including implants, soft tissue grafts, bone grafts, and free tissue transfer.

Parry Romberg syndrome (aka progressive hemifacial atrophy) is a condition where half of a person’s face begins to waste away.

This may involve skin and fat only, or can also affect the muscle, bone, and cause pain.

Sometimes only a part of the face is involved, like the forehead or the cheeks. Other times, migraine headaches, changes in pigment, or shrinking of half of the tongue is seen.

Most commonly Parry Romberg syndrome begins at puberty. We have seen patients of all ages affected, though, often after a viral infection or trauma.

Treatment most commonly involves fat grafting. This involves liposuction of fat from an unaffected area like the flank, and transferring the fat in small amounts to the affected area.

Typically anywhere from 1/3rd to 2/3rds of the transferred fat takes hold and persists long-term.

Treatment may involve multiple rounds of grafting to achieve reasonable symmetry, and sometimes is repeated over the years as facial fat and the transferred fat may age differently.

Other options for treatment are available as well, including implants, bone grafts, and free tissue transfer.

This patient is seen 1 month after her second round of fat grafting. Photos, as always, shared with verbal and written consent.

This man came to us with severe facial asymmetry even after over 10 surgeries elsewhere for Parry Romberg Syndrome.

Those surgeries included 2 free flap surgeries, but he still had a fair amount of asymmetry and tightness of the upper cheeks and soft tissue on the entire left side of his face.

He has since gone through two surgeries with us.

He is a full year since a dermal-fat graft to the cheek, and fat injections around the eye and cheek. The grafting has held up well, with no further fat grafting nor fillers since then.

More recently, a few weeks ago we performed a septorhinoplasty with cartilage and acellular dermal grafting, via a closed approach (no incision across the columella).

Some cartilage did come from his ear, and in the process that ear was intentionally set back to improve that ear symmetry despite the severely asymmetric bony base.

His breathing has improved as well, and he is happy with the improvements we’ve been able to make!