Nasal and Oral Subunits Reconstruction of Localized Scleroderma Deformities

Localized scleroderma is a rare soft tissue disorder characterized by a thickening of the skin from excessive collagen deposits. For patients with face involved, soft tissue depression and atrophy could cause serious facial contour deformity and adversely affect the patients' quality of social life. However, localized scleroderma cases with delicate facial aesthetic subunits defects were rarely reported to be surgically reconstructed. In this study, we present 2 patients with nasal subunits and oral subunit deformities caused by localized scleroderma respectively. The first patient with a right-side alar defect and nasal dorsum depression, forehead depression and eyebrow depression were treated through a 2-stage surgical approach, with microvascular preauricular and helical rim flap and dermofat graft transplantation. The lower lip and mandible defects of the second patient were reconstructed with a combination of submental flap and fat grafting. The transplanted dermofat graft, fat graft, the microvascular free flap, and the submental flap survived completely and maintained adequate tissue volume and facial contour during the follow-up time of 2 years. Both patients were satisfied with the overall aesthetic results. This clinical report supports the use of microsurgical flap and tissue grafts on the treatment of localized scleroderma (LS) caused facial aesthetic subunits deformities.