Bilateral facial lipoatrophy secondary to connective tissue panniculitis treated with two microsurgically transplanted latissimus dorsi muscles

A case of bilateral facial atrophy diagnosed as atrophic connective tissue panniculitis is presented. Reconstruction of both cheeks was performed with two staged latissimus dorsi muscle flaps. The initial good result on the right cheek deteriorated as the disease continued to progress after surgery. The good result on the left cheek, however, remained stable. Detailed clinical examinations, laboratory analysis, and deep biopsies from the affected areas are important for accurate diagnosis. Reconstructive procedures should be delayed while the disease is still active.