Hello Doctors, I'm 26 yr old, I've progressive hamifacial atropy & en coup de sabre morphea on the right side of face. My upper right lip, right side beside the nose & forehead have hyper-pigmented scar & depression due to the disease. Past March I went under fat transfer procedure for depression correction, but the 98% fat got absorbed within a month. My surgeon told me it'll take 2 more sittings. Should I go for 1 more sitting or I've alternative choice? And what about the scar?
Best Procedure for Progressive Hamifacial Atrophy Correction?
Doctor Answers 4
Fat Transfer - Take Rates - Adivive and Dermasculpt
The issue of fat retention in fat transfer remains one of the most complicated aspects of this procedure. There are a multitude of techniques and ideas on how to improve fat transfer take rates. From my experience looking at various techniques, I believe two things really matter. The first is the methodology for preparing the fat after harvest. The second is the technique for injecting the fat.
In my opinion, the best method for fat preparation is the Palomar Adivive system. I have consistently seen much higher fat retention rates with this system than anything else I have tried. In terms of injection, I believe the needle one uses is incredibly important. To this end, the Dermasculpt line of needles are the best to insure proper fat layering.
Finally, the area of fat transfer that excites me most is combining fat with protein rich plasma. I believe this has great future potential. Good luck.
Fat is your best option
Your own fat is the best option for correction of hemifacial atrophy. Depending on the size of the area that needs to be treated and the severity, you have two options. First is a fat grafting procedure where fat is harvested and re-injected after being gently processed. This does have a tendency to resorb some (although 98% is too much to expect). The second, for severe cases, is a fat transfer taken as a vascular flap (usually from your back) and contoured to match the other side of your face. This is a much more involved procedure, but works well for severe cases.
Find a board-certified plastic surgeon with experience in microsurgery and craniofacial surgery to discuss all your options.
Hope this helps,
There are some alternatives that can be used. Firstly, in some areas of the face, permanent implants may be used. For example, if you have enophthalmos [sunken eye] due to fat atrophy, you may be able to have implants within the eye socket to push the eye out further.
Furthermore you could use fillers such as Sculptra to help stimulate collagen production. Use of these fillers in a disease such as yours is less predictable however.
Fat grafting may still be your best option and multiple sessions is not unusual.
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Best available treatment at the present time is fat transfer. It should be done when the disease has stabilized and no more atrophy