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The overall goals of treatment are improving facial balance, symmetry, and function
Even "gently." If you suspect mixing technique caused cloudiness, sometimes letting the vial sit refrigerated for 1-2 hours will allow some of the aggregation to disperse but typically the damage is done
In many patients with severe primary IGF-I deficiency (SPIGFD) defined by low IGF-I (less than 3 SDS or the 2.5 th percentile), severe short stature (Height SDS less than 3), normal GH secretion and absence of acquired insensitivity to GH (discussed below) genetic defects may be absent
