Two- and Three-Dimensional Quantification of Facial Symmetry After Fat Grafting and Free Flap Reconstruction in Hemifacial Atrophy

Peking Union Medical College60 enrolled

Overview

Hemifacial atrophy causes one side of the face to become smaller, leading to facial asymmetry. Surgeons often restore facial volume using either autologous fat grafting or free-flap reconstruction. However, it is not fully clear how much facial symmetry improves after surgery when measured objectively using two-dimensional (2D) photographs and three-dimensional (3D) surface scans. This is a single-center, retrospective observational study of patients with hemifacial atrophy treated between January 2020 and December 2023 at \[Plastic Surgery Hospital, Chinese Academy of Medical Sciences \& Peking Union Medical College\]. We will quantify facial symmetry before surgery and at the first follow-up visit occurring at or beyond 6 months after the initial surgery. Symmetry outcomes will be assessed using standardized 2D photographs for all included patients, and 3D surface scans for a subset of patients. Complications will also be assessed at the first ≥6-month follow-up visit. We will compare changes in symmetry between patients treated with fat grafting and those treated with free-flap reconstruction.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Hemifacial Atrophy

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: Diagnosis of hemifacial atrophy (Parry-Romberg syndrome). Underwent initial soft-tissue augmentation with either autologous fat grafting or free-flap reconstruction at the study center between January 2020 and December 2023. Availability of standardized preoperative assessment and postoperative assessment at the first follow-up visit occurring ≥6 months after surgery (2D photographs required). Exclusion Criteria: Follow-up \<6 months after the initial surgery. Missing key imaging/photographic data required for outcome assessment. Any additional facial augmentation or revision procedure performed before the first ≥6-month follow-up visit.

Outcomes

Primary Outcomes

Change in 2D Facial Symmetry Ratio

Facial symmetry ratio calculated from standardized frontal 2D photographs using computerized photogrammetric analysis. The primary endpoint is the change from preoperative baseline to the first postoperative follow-up visit occurring at or beyond 6 months after the initial surgery.

Time frame: Baseline (preoperative) and first follow-up visit 6 months postoperatively

Secondary Outcomes

Change in 3D Volumetric Discrepancy Between Hemifaces

Three-dimensional (3D) volumetric discrepancy between the affected and unaffected hemiface measured from 3D surface scans in the subset of participants with available 3D data. Change from baseline to the first ≥6-month follow-up visit.