Background: Progressive facial hemiatrophy, also called Parry-Romberg syndrome (PRS), is characterized by slowly progressive atrophy of one side of the face and primarily involves the subcutaneous tissue and fat. The restoration of facial contour and symmetry in patients affected by PRS still remains a challenge clinically. Fat graft is a promising treatment but has some shortcomings, such as unpredictability and low rate of graft survival due to partial necrosis. To obviate these disadvantages, fat graft assisted by bone marrow–derived mesenchymal stem cells (BMSCs) was used to treat PRS patients and the outcome was evaluated in comparison with the conventional treatment by autologous fat graft.
Methods: Autologous fat graft was harvested by tumescent liposuction. Bone marrow–derived mesenchymal stem cells were then isolated by human Lymphocytes Separation Medium through density gradient centrifugation. Twenty-six patients were treated with autologous fat graft only (group A), whereas 10 other patients were treated with BMSC-assisted fat graft (group B). The Coleman technique was applied in all fat graft injections.
Results: The follow-up period was 6 to 12 months in this study, In group A, satisfactory outcome judged by symmetrical appearances was obtained with 1 injection in 12 patients, 2 injections in 8 patients, and 3 injections in 4 patients. However, the result of 1 patient was not satisfactory and 1 patient was overcorrected. In group B, 10 patients obtained satisfactory outcomes and almost reached symmetry by 1 injection. No complications (infection, hematoma, or subcutaneous mass) were observed.
Conclusions: The results suggest that BMSC-assisted fat graft is effective and safe for soft tissue augmentation and may be superior to conventional lipoinjection. Additional study is necessary to further evaluate the efficacy of this technique.
*Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi; and †Department of Plastic Surgery, Chinese PLA General Hospital, Beijing, China.
Received March 23, 2014, and accepted for publication, after revision, March 25, 2014.
Conflicts of interest and sources of funding: none declared.
Reprints: Yi Chenggang, MD, PhD, Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, #15 Changlexilu, Xi’an City, Shaanxi Province 710032, China. E-mail: firstname.lastname@example.org.
Zhao Jianhui and Yi Chenggang contributed equally to this research.
Supported by the National Natural Science Foundation of China (30973132), and the Key Program of Military Medical Research of the 12th Five-Year Plan (BWS11C061).