Localized scleroderma (LS) is an inflammatory sclerosing disease of unknown etiology characterized by progressive damage to connective tissue followed by the formation of sclerosis and/or atrophy of the skin and underlying tissues. The prevalence of LS is 27 cases per 1 million population per year, of which 3.4 cases occur in children. As follows from the data and the series of clinical cases we have described, conservative therapy with systemic medications does not address the aesthetic problem in localized scleroderma, which causes aesthetic dissatisfaction in the majority of patients. Fibrous and destructive changes in adipose tissue and skin depigmentation lead to subsequent phenotypic changes and facial atrophy. Allogeneic adipose tissue is an ideal material because it is completely autologous, which is very important for patients with autoimmune processes. Thus, surgical treatment of children using autologous fat tissue allows to alleviate severe facial defects, improve the quality of life of children with LS, and increase their level of social adaptation.