Why can I see my depressor? (Photo)

Question

I don’t know what’s going on. Only the right side of my face seems to have lost fat and I can visibly see my depressor muscle. Also, right above it looks like a fat pocket? Not sure, because when I purse my lips, that too feels like a muscle bulging. If I pull my skin back on lower face, I can still see this muscle when I smile. Is this lipotrophy in this are? My temple is also very hollow and my cheek is smaller than left side. My right side of my face doesn’t feel as thick as my left.

Mats Hagstrom, MD (license on probation) · Answer

It sounds like you may have Parry-Romberg syndrome is a rare condition that involves a slow breakdown and wasting away (atrophy) of the skin and soft tissues of the face. It can also cause the muscles, cartilage, and bones of the face to deteriorate. Parry-Romberg syndrome can affect the brain and cause neurological problems, as well as involve the jaws and eyes. It usually occurs on the left side of the face, with progressive shrinking and deterioration.
The changes in skin usually start at the middle of the face, like the upper lip or below the nose before spreading out toward the eye, ear, and neck. The tongue, gums, and roof of the mouth can also be affected. Some people may have seizures or periods of major pain of their face.
The exact cause of Parry-Romberg syndrome is not known, but some cases may be a result of trauma, are seen in families (hereditary), or may involve infection or autoimmune causes
Neurological symptoms may include:
SeizuresWeakness on one side of the body Migraine or other headachesBrain atrophy Facial pain Trigeminal neuralgiaVision problems (from damage to the retina and optic nerve)Symptoms generally begin in childhood or adolescence and last for two to 20 years from onset before stabilizing. Computed tomography (CT) and magnetic resonance imaging (MRI) are most often used to diagnose neurological complications. Parry-Romberg syndrome is more common in females than males. Symptoms can be very different for each case. In rare cases, some people may have the skin break down on the arm or chest on the affected side.
Currently, there is no cure or treatment to slow or prevent the deterioration caused by Parry-Romberg syndrome. Surgery may be needed to rebuild the damaged tissue and skin, and some cases may need a bone or muscle transplant. Immunosuppressant drugs and other medicines may help treat some neurological symptoms. Other treatment focuses on treating other symptoms.
Consider having a few in person, consultations with plastic surgeons in your area. If you have an academic medical Center near you, that may be a good place to seek care.
This is not a diagnosis, but one condition that is worth looking into and ruling in or out.
Best,
Mats Hagstrom MD

Why can I see my depressor? (Photo)

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Why can I see my depressor? (Photo)

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