Facial lipodystrophy is a relatively rare disease and very little has been reported concerning the reconstruction of this facial deformity compared with Romberg's disease. In this article we report a new surgical procedure using a double paddle radial forearm dermis--fat free flap. By using this unique flap, we could reconstruct soft tissue defects on both cheeks in a one-stage operation using one flap. In the previous conventional procedure, two flaps are required for the reconstruction of bilateral defects on the face. Therefore, we also made a comparison between our flap and the conventional flap with regard to their advantages and disadvantages. Although this is a limited experience, we think using this flap is a preferable method of treating facial lipodystrophy.