Do sunken facial features indicate progressive atrophy?

Question

Hello doctor,

I have a night shift job. For the past couple of years, my face has lost volume. I have hollow cheeks, temples, and eyes. The left side of my face is more sunken, and I also feel that I have lost some bone on the left side of my nose. The condition is worsening with time. Also, it is having an impact on my confidence and mental health. Do these symptoms indicate Parry-Romberg syndrome? I have attached the pictures for your reference.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I have reviewed the attached pictures (attachment removed to protect the patient's identity). You have a condition called progressive hemifacial atrophy. It is a degenerative disease that affects one side of the face. There can also be some neurological complications like headaches, seizures, severe facial pain, and eye involvement. The other symptoms are bone involvement leading to osteoporosis, progressive degeneration of the skin, soft tissues, and fat below the skin. Depletion of the tissues leads to craniofacial asymmetry and marked changes in appearance.

There are a variety of corrective surgical techniques available to treat the condition. I suggest you go for reconstructive and microvascular surgery to repair the wasted tissue. Also, you can choose treatments like bone grafts and fat transfer. I also suggest tablet Amitryptiline 10 mg daily at night for 25 days to help improve your mood. Consult a specialist doctor, talk to him or her, and start the treatment with their consent.

I hope this helps.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Your appearance is affecting your psychological growth and intellectual development. Deflection from normal appearance also poses psychosocial difficulties. I suggest you go for facial reconstructive surgery that involves correcting the facial asymmetry using fat grafts. Fat graft is harvested from your abdomen and gluteal region and is sculpted and inserted beneath the skin of the affected region to restore the symmetry of your face. Also, the use of chewing gum and physiotherapy can help you.

I hope this helps.

Thank you.