Foba M L, Mégevand V, Scampa M, Teuw E H D, Quinodoz P, Sankale A-A, Kalbermatten D F, André-Lévigne D
Department of Plastic, Reconstructive and Aesthetic Surgery, CHNU de Fann, 15186 Dakar Fann, Senegal.
Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, HUG, 1205 Geneva, Switzerland.
JPRAS Open. 2025 May 11;45:113-126. doi: 10.1016/j.jpra.2025.05.003. eCollection 2025 Sep.
Progressive hemifacial atrophy (PHA), including en-coup-de-sabre morphea and Parry-Romberg syndrome, is a rare condition characterized by unilateral atrophy of facial tissues. The etiology of PHA remains unclear, though it is generally considered to be an autoimmune disease. Current treatment approaches typically involve systemic immunosuppression to stabilize the disease, followed by reconstructive surgery to restore facial symmetry, ranging from complex flap reconstruction to autologous fat transfer (AFT) and allogenic fillers. Recent evidence supports AFT not only as a volumetric filler but also for its immunomodulatory and angiogenic properties, making it a promising supplement or even alternative to systemic immunosuppressive therapy.
We present four cases of PHA treated with AFT in Dakar, Senegal, and Geneva, Switzerland. A comprehensive review of evidence supporting AFT as a cellular therapy in patients with PHA was performed discussing its potential as an effective stand-alone therapeutic option.
There is growing evidence that AFT has regenerative effects in fibrotic autoimmune disease, including scleroderma and PHA. This is in line with our results showing not only improved facial contours and a restoration of symmetrical fullness but also improved overall tissue quality after AFT.
We advocate AFT to be a safe and reliable therapy in PHA, offering not only a substitute to the lost tissue but also local immunomodulatory benefits useful for tissue regeneration. Besides the benefits of combining local immunomodulatory cell therapy with the reconstructive volume restoration, this technique offers a low risk profile, cost-effectiveness and excellent accessibility, particularly relevant in low-income settings.
进行性半侧颜面萎缩（PHA），包括剑伤样硬斑病和帕里 - 罗默综合征，是一种罕见病症，其特征为面部组织的单侧萎缩。PHA的病因尚不清楚，尽管一般认为它是一种自身免疫性疾病。目前的治疗方法通常包括全身免疫抑制以稳定病情，随后进行重建手术以恢复面部对称性，范围从复杂的皮瓣重建到自体脂肪移植（AFT）和异体填充剂。最近的证据支持AFT不仅作为一种容积填充剂，还因其免疫调节和血管生成特性，使其成为全身免疫抑制治疗的一种有前景的补充甚至替代方法。
我们展示了在塞内加尔达喀尔和瑞士日内瓦用AFT治疗的4例PHA病例。对支持AFT作为PHA患者细胞治疗的证据进行了全面综述，讨论了其作为有效独立治疗选择的潜力。
越来越多的证据表明AFT在包括硬皮病和PHA在内的纤维化自身免疫性疾病中具有再生作用。这与我们的结果一致，结果显示AFT后不仅面部轮廓改善和对称性丰满度恢复，而且整体组织质量也得到改善。
我们主张AFT在PHA中是一种安全可靠的治疗方法，不仅能替代丢失的组织，还能提供对组织再生有用的局部免疫调节益处。除了将局部免疫调节细胞治疗与重建性容积恢复相结合的益处外，该技术风险低、成本效益高且易于实施，在低收入环境中尤为重要。
