Q: Dr. Eppley, I have interest in consulting regarding dermal fat drafting surgery . I have been researchimg for sooo long hoping to find something like this. I was diagnosed with linear scleroderma a few years ago and have noticed my top frontal area become more and more darker and indented. I am a 33 year old mother of three and since this diagnosis and physical apperance, it has caused great emotional damage and even depression. It has been an extremely difficult time understanding this and dealing with it, having to explain it to my friends and family. Please help. Thank you for your time,
A: Linear scleroderma is both a peculiar and frustrating craniofacial affliction. The first place to start is to send some pictures for my assessment and recommendations. By your description you appear to be in the active phase of the disease and it involves the forehead and up into the scalp undoubtably along the pathway of the supraorbital nerve. The classic teaching is that one should not treat the deformity until the disease process has abated and the tissue loss has stabilized. While that certainly makes the most sense from a reconstructive standpoint that is usually not very comforting to patients. I have often taken a different approach which is to try to stop the tissue deformation progression by early tissue grafting. Whether this should be done by the implantation of a dermal-fat graft from an abdominal harvest or fat injections with PRP (platelet-rich plasma) is up for discussion. With either fat grafting technique, it may take more than one treatment session to get sustained results.
Dr. Barry Eppley