**4. Clinical cases**

#### **4.1 Case 1 – Parry Romberg syndrome**

The patient is a 35-year-old man with no previous medical history, diagnosed with progressive right hemifacial atrophy of 10 years evolution and 5 years with a stabilized condition. On examination, alopecia was found in the parietal and temporal region, together with subcutaneous tissue atrophy of the temporal region and the right midface, tooth loss, decreased range of motion of the temporomandibular joint, and trigeminal neuralgia. Three-dimensional (3D) reconstruction computed tomography showed the absence of the temporomandibular joint and a significant reduction of tissue volume in the affected side.

Infiltration with enriched autologous fat containing ASCs reduced the severe depression of the frontotemporal region and provided better volume and symmetry. An acceptable improvement of the malar prominence and cheek was also achieved, with greater volume and projection on the front view and profile. From its angle to the chin, the mandibular contour was redefined, achieving a better balance; even the neck base benefitted volumetrically. It is important to point out the

permanence of the fat graft in the lips, which allowed the teeth to be hidden because of increased lip volume. The graft's permanence remained stable in all the injected areas, even in the nasolabial folds and lips, which are areas of maximum mobility and reabsorption [24] (**Figure 2**).
