Autologous adipose tissue transfer in progressive hemifacial atrophy: From simple volume to regenerative cell therapy.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background 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. Methods 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. Results 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. Conclusion We advocate AFT to be a safe and reliable therapy

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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