Plastic Surgery for Facial Hemiatrophy with Facial Paralysis

  Objective  To explore the plastic surgery to treat facial hemiatrophy combined with facial paralysis.

  Methods  From March 2006 to March 2012, 12 patients of facial hemiatrophy with facial paralysis were treated in Department of Plastic Surgery of Peking Union Medical College Hospital, including 3 males and 9 females. Their ages ranged from 16 to 49 years. The average duration of facial hemiatrophy was 6.9 years (5-30 years), and the average duration of facial paralysis was 4.5 years (2-18 years). Several reconstructive procedures were applied for reconstruction of appearance and function, taking into consideration of the individual conditions of each case. For correction of facial hemiatrophy with facial paralysis, dermis-fat grafts were used in 4 patients, groin dermis-fat free flaps in 2, and extensor pollicis brevis and extensor digitorum brevis free flaps combined with suspension in 6. To achieve the satisfied symmetrical results, nasolabial fold suspension and additional fat injection at the depression edge of the graft were performed.

  Results  The adipofascial flaps survived in all the 12 patients. The incisions all healed without fat liquefaction or other complications. In the follow-up of 0.5-6 years, all the patients were satisfied with the results. The facial contour of all the patients were well corrected.

  Conclusion  Dermis-fat free grafts combined with free small muscle free grafts could achievesatisfied symmetrical effect for patients of facial hemiatrophy with facial paralysis.