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Case report
Oro-facial fibrosis in systemic sclerosis: a reconstructive journey
  1. Faith Hyun Kyung Jeon1,2,
  2. Michelle Griffin1,2,3,
  3. Jajini Varghese1,3 and
  4. Peter Edward Michael Butler1,2,3
  1. 1Division of Surgery & Interventional Science, University College London, London, UK
  2. 2Charles Wolfson Centre for Reconstructive Surgery, Royal Free London NHS Foundation Trust, London, UK
  3. 3Plastic & Reconstructive Surgery, Royal Free London NHS Foundation Trust, London, UK
  1. Correspondence to Dr Faith Hyun Kyung Jeon; h.jeon{at}


Oro-facial fibrosis presents a significant disease burden in patients with systemic sclerosis, but there remains no established treatment modality. Autologous fat grafting is a minimally invasive surgical procedure that is now increasingly recognised for its regenerative capacity, propagating an expansion of heterogeneous indications beyond volume restoration, including fibrotic diseases such as systemic sclerosis. We present a 42-year-old woman with oro-facial involvement of systemic sclerosis leading to severe limitation in mouth opening and closure, with marked retraction of the lower lip and gingival display. We describe the reconstructive journey over a 12-year period, where the antifibrotic effect of autologous fat grafting served as the basis on which a series of surgical procedures were performed to achieve functional and aesthetic improvement. Autologous fat grafting provides a novel treatment modality for oro-facial skin fibrosis, previously considered a non-treatable disease manifestation of systemic sclerosis.

  • plastic and reconstructive surgery
  • rheumatology
  • connective tissue disease
  • mouth

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  • Contributors All authors have seen and approved the final manuscript. All authors have made substantial contributions to all of the following: (1) conception and design of the study (MG, PEMB), or acquisition of data (FHKJ), or analysis and interpretation of data (FHKJ, JV); (2) drafting the article or revising it critically for important intellectual content (FHKJ, MG, JV); (3) final approval of the version to be submitted (FHKJ, MG, JV, PEMB).

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.