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A 35-year old female presented to us with deformity on the right side of the face. The patients history revealed the occurrence of an indurated area on the right side of the face 19-years prior to the date of reporting. The indurated area showed gradual increase in the pigmentations and progressive atrophy on the same side of the face over the years. Previous attempts of treatment with cortico-steroids showed limited reduction in pigmentations. History of progressive increase in mobility of the tooth on the same side of the jaw lead to multiple uneventful extractions. On examination atrophic changes were observed on the right lower third of the face with corrugation of the skin near the angle of the mouth. Wrinkled appearance of the overlying skin due to lack of subcutaneaous fat was evident on the right side. The changes were only restricted to right side of the midline (Figure 1). Hyper pigmented areas with stretched shiny appearance was observed over the right malar region. This was in sharp contrast to the normal appearing left side of the face. Based on these clinical finding and characteristic history provided by the patient a clinical diagnosis of hemifacial atrophy was made. Since the condition did not cause major esthetic concern, the patient was advised regular follow up.