Blog - Balaji Dental and Craniofacial Hospital

[vc_section content_layout=”full” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_row content_layout=”boxed” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=””][vu_heading style=”2″ heading=”Patient born with a cleft lip, palate and alveolus to closely related parents” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]The patient is a 3-month-old baby from Pathankot in Punjab, India. She was born with a right-sided cleft lip, palate and alveolus. Of note, there is a family history of an uncle with a cleft lip, palate and alveolus deformity. Her father’s younger brother was born with the same deformity on the left side. Mother had undergone routine prenatal care including an ultrasound of the fetus. This revealed the cleft deformity in the growing fetus. The parents were however unfazed by this development. Her uncle had undergone surgical correction of his facial deformities at our hospital nearly two decades ago.[/vc_column_text][vu_heading style=”2″ heading=”Total rehabilitation of her uncle for his cleft deformities at our hospital” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]He had undergone cleft lip repair at 3 months and cleft palate repair at 8 months. His speech difficulties had been corrected by a pharyngoplasty at 3-1/2 years of age. As his cleft alveolus deformity had been significant, he had undergone bone grafting at 5 years of age. He had hardly noticeable scarring from the surgeries and had never faced any difficulties secondary to his deformities. Always an excellent student, he is now pursuing his undergraduate studies in medicine. His ambition is to become a facial plastic surgeon dealing with congenital deformities of the face. Parents had got in touch with our hospital soon after the ultrasound diagnosis for their child. Dr SM Balaji studied the ultrasound images in detail. He then advised them to come to the hospital when the child was 3 months old.[/vc_column_text][vu_heading style=”2″ heading=”International accolades for the cleft surgical correction services of our hospital” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]Our hospital is a preeminent center for cleft deformity surgery in India. Dr SM Balaji is on the board of the International Cleft Lip and Palate Foundation (ICPF) of Japan. Prof. Kenneth Salyer, Founder of the World Craniofacial Foundation (WCF) has made our hospital a referral center for Southeast Asia. Cleft repairs are routinely performed in our hospital. Facial plastic surgery is also a specialty offering at our hospital. Scores of patients have been rehabilitated with the optimum cosmetic outcomes. Nasal mucosal reconstruction and soft palate repair is also a component of cleft palate repair.[/vc_column_text][vc_row_inner animation_delay=”” disable=”” id=”” class=””][vc_column_inner width=”1/2″ vertical_align=”top” animation_delay=””][vc_single_image image=”6945″ img_size=”full” add_caption=”yes”][/vc_column_inner][vc_column_inner width=”1/2″ vertical_align=”top” animation_delay=””][vc_single_image image=”6946″ img_size=”full” add_caption=”yes”][/vc_column_inner][/vc_row_inner][vc_row_inner animation_delay=”” disable=”” id=”” class=””][vc_column_inner vertical_align=”top” animation_delay=””][vu_heading style=”2″ heading=”Initial presentation at our hospital for consultation of her cleft deformity correction” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]Parents presented at our hospital when the child had attained 3 months of age. Her uncle too accompanied them. He was very familiar with all the members of the surgical team and greeted them. Everybody expressed their happiness at the great strides he was making towards attaining his ambition. Dr SM Balaji, cleft lip and palate surgeon, examined the child. She had a buckled columella from the cleft deformity. There was also a split upper lip from the right-sided cleft lip defect. She also had a widened alar base defect to the nose. Dr SM Balaji counseled the parents extensively. He said that the cleft lip surgery would be followed by cleft palate surgery at 8-10 months of age. Explaining further, he said that rh-BMP might be required for the cleft alveolus if the defect was large. Pharyngoplasty might also be required if the patient develops any speech problems. Meticulous treatment planning was performed for the patient. It was decided to perform a modified Millard’s cleft lip repair for the patient. Her parents expressed complete confidence with the treatment plan and consented to surgery.[/vc_column_text][vu_heading style=”2″ heading=”Successful surgical correction of right-sided cleft lip and nasal floor deformity” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]Under general anesthesia, surgery was first begun with an incision along the philtrum with dissection down to the subcutaneous tissues. The nasal floor defect was addressed first. The nasal floor was reconstructed using the flap. The nasal sill was then reconstructed using a C-flap. A three layer lip closure was utilized as it offered the best cosmetic and functional results for the patient. The skin, subcutaneous connective tissue and muscles were reapproximated and joined with great precision. This resulted in optimal reconstruction of the lip vermillion border, philtrum and orbicularis oris muscle. Nasal floor was reconstructed by raising the alar base. This gave good symmetry to the nasal correction. Fine 4-0 Vicryl sutures were used to close the incision in layers for minimal scar formation. The entire surgical procedure was performed under magnification through utilization of a surgical loupe.[/vc_column_text][vu_heading style=”2″ heading=”Optimal postoperative results by the seventh postoperative day” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]The patient was gurgling and cooing by the seventh postoperative day. Scarring was minimal and would reduce further with the passage of time. The proud parents and uncle were extremely happy with the results of the operation. Patient had a good suckling reflex and had gained nearly 1 kg within the few days following surgery.[/vc_column_text][vu_heading style=”2″ heading=”Further instructions given to the parents and uncle regarding patient” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]It was further reiterated to them that the road to complete rehabilitation was a long one for the patient. They expressed their complete confidence in the surgical team, which was essentially unchanged from the one that had treated the uncle. Expressing their thankfulness to everyone, they said that they will return in a few months for the cleft palate repair.[/vc_column_text][vc_video link=”https://youtu.be/H0CaPoQspM0″ title=”SURGERY VIDEO”][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row][/vc_section]

The patient is a 22-year-old male from Chennai in Tamil Nadu, India. He was relaxing at home on a weekend after completing his examinations. Walking into the balcony of his house in the dark,

The patient is a 22-year-old male from Chennai in Tamil Nadu, India. He began feeling a heaviness in the maxillary region about a year ago. The tone of his voice also felt muffled.

[vc_section content_layout=”full” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_row content_layout=”boxed” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=””][vu_heading style=”2″ heading=”Patient born with a unilateral cleft lip, palate and alveolus deformity” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]The patient is a 3-month-old female infant from Ajmer in Rajasthan, India. She was born with a left-sided cleft lip, palate and alveolus deformity. Her upper lip was split because of the cleft lip. There was a communication between the oral and nasal cavities through the roof of the mouth. This had devastated the parents. Cleft defects are the most common form of birth defects affecting newborns. Hospital staff had provided extensive counseling for the family and educated them about the condition. Parents were most distressed by her feeding difficulties. Friends had informed them that they needed to approach a facial plastic surgeon.[/vc_column_text][vu_heading style=”2″ heading=”Contact with parents of another child who had undergone cleft deformity repair previously” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]The hospital had referred the parents to the parents of another child who had been born with cleft deformity a few years ago. Parents immediately got in touch with them. They also met the child who had been born with a cleft defect. The child was now 6 years old and appeared normal with completely normal speech. The parents were informed that Dr SM Balaji had operated on their daughter. They also informed that this surgery had been a little over five years ago. All their fears regarding the deformity affecting their child had been allayed over the years following cleft surgery. They said that their daughter had not faced any problems because of her cleft defect. Parents immediately obtained contact information about our hospital and got in touch with our hospital manager. They had then been given an appointment to meet Dr SM Balaji for a consultation.[/vc_column_text][vu_heading style=”2″ heading=”Center of excellence for cleft lip repair in the entire Southeast Asian region” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]Our hospital is a premier cleft lip surgery hospital in India. We are recognized as a center of excellence for cleft lip surgery by the International Cleft Lip and Palate Foundation (ICPF) of Japan. We are the proud recipients of the prestigious ‘Prof David Precious Award.’ This was awarded in recognition of innovations developed by us for the rehabilitation of cleft patients. We are also an affiliate of the Dallas-based World Craniofacial Foundation (WCF).[/vc_column_text][/vc_column][/vc_row][vc_row content_layout=”boxed” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column width=”1/2″ layout=”normal” vertical_align=”top” animation_delay=””][vc_single_image image=”6926″ img_size=”full” add_caption=”yes”][/vc_column][vc_column width=”1/2″ layout=”normal” vertical_align=”top” animation_delay=””][vc_single_image image=”6927″ img_size=”full” add_caption=”yes”][/vc_column][/vc_row][vc_row content_layout=”boxed” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=””][vu_heading style=”2″ heading=”Initial presentation at our hospital for rehabilitation of her cleft lip defect” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]Dr SM Balaji, cleft repair surgeon, examined the patient. The patient had buckling of the columellar cartilage. There was a widened alar base defect and the floor of the nose was nonexistent. The nasal sill was also absent on the left side. There was also a cleft alveolus defect. It was explained to them that modern surgical intervention would leave minimal discernable scars depending upon the skin condition. They were reassured that the patient would lead a completely normal life. The surgical schedule was explained to them in detail. Importance of adhering to the timetable was explained to them.[/vc_column_text][vu_heading style=”2″ heading=”Correct time schedule for performing each step of cleft deformity repair” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]They were informed that cleft lip surgery needed to be done at 3 months of age. This would be followed by cleft palate surgery at 8-10 months of age. Cleft alveolus repair may be needed between 4-5 years of age. This will be performed with rh-BMP if there is a large alveolar defect. Pharyngoplasty may also be required if the patient develops speech problems. Speech therapy would also be needed in case of issues with speech. Meticulous treatment planning was performed for the patient. Thorough biometric studies were ordered and a projection of growth was predicted for the reconstruction and surrounding structures. A modified Millard’s cleft lip surgery would be performed for repair of the patient’s cleft lip. This planning protocol would ensure the best possible symmetric and functional repair for the patient. Parents expressed understanding and consented to surgery.[/vc_column_text][vu_heading style=”2″ heading=”Successful repair and reconstruction of unilateral lip and nasal deformities” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]Under general anesthesia, an incision was made along the philtrum and dissected down to the subcutaneous tissues. Attention was first turned to the nasal floor defect. This was then reconstructed. A C-flap was raised for recreation of the nasal sill. A surgical loupe was used to visualize the surgical site during the entire procedure. It was decided to utilize a three-layer closure of skin, subcutaneous tissue and muscle to obtain the best possible esthetic results. There was good recreation of the vermillion, philtral column and orbicularis oris. Nasal floor recreation resulted in raising of the alar base. Fine 4-0 Vicryl sutures were utilized for closure of the cleft defect.[/vc_column_text][vu_heading style=”2″ heading=”Successful postoperative healing of cleft defect with optimal results” subheading=”” alignment=”left” custom_colors=”” class=””][vc_column_text]By the seventh day following surgery, there was just minimal scarring at the site of the surgical repair. The patient had developed a good suckling reflex following surgery and began to feed well, gaining weight. Establishment of symmetry of the lips results in pleasing facial esthetics. Parents were very happy with the results. It was explained to the parents that this was just the first step in the long road to rehabilitation for the patient. They expressed complete understanding of this and were committed to sticking to the surgical schedule that had been provided to them.[/vc_column_text][vc_video link=”https://youtu.be/3ozYKROb4vQ” title=”Surgery Video”][/vc_column][/vc_row][/vc_section]

Young lady who has long desired to undergo cosmetic nose correction for long nose The patient is a 23-year-old female from Nagpur in Maharashtra, India. She has always felt that her nose was not in harmony with her cheek bone structure. Feeling that it did not suit her facial features, she had long desired long nose cosmetic reduction surgery. Her parents had said that she needed to finish her studies before she underwent this procedure. Having finished her studies, they decided that this was the ideal time to do this. They had approached a leading plastic surgeon in her hometown for this. He undertook various facial analyses to study her nose and its relationship to her face. Realizing that this needed to be performed by a rhinoplasty specialty surgeon, he had referred them to our hospital. Our hospital is a leading facial cosmetic surgery hospital in India. We perform both cosmetic nose surgery as well as nasal deformity surgery. Cleft rhinoplasty correction is a superspecialty offering in our hospital. Cleft lip nasal deformity rehabilitation has restored the lives of many patients. We have two state of the art operating theaters for performing all surgeries. Many successful celebrities from fields as diverse as media, films and sports have undergone corrective rhinoplasty at our hospital. The patient and her family immediately got in touch with our hospital manager. She said that she wanted a cosmetic nose job. They were asked to report to our hospital for an initial consultation. Initial presentation at our hospital for definitive correction of her long nose deformity Dr SM Balaji, cosmetic rhinoplasty specialist, examined the patient and obtained a detailed history. She expressed her displeasure at the length of her nose. Another issue that bothered her was the breadth of her nostrils, which she felt were excessively flared. She desired to undergo cosmetic correction of these two issues. A closed rhinoplasty would be the ideal approach to avoid scar formation. He then ordered detailed facial measurements along with nasal dimensions for the patient. Various cephalometric and other parameters were then utilized to determine the best nasal form for the patient’s face. The patient was educated about cosmetic surgery and what to expect from it. Time was spent listening to the patient to understand her expectations better. A detailed treatment plan was then formulated to address the patient’s issues. This would involve reduction of the nasal cartilages to reduce the length followed by Weir excision for alar reduction. The procedure was explained to the patient and her parents who consented to the surgery. Successful reduction of the length of nose to a perfectly esthetic form The patient was prepped and draped for surgery. Careful measurements were made pertaining to all the surgical landmarks. Under general anesthesia, intranasal incisions were made and the lower lateral cartilages were reduced. This was then followed by reduction of the upper caudal part of the nasal septum. A T-shaped strip of cartilage was then removed through an intranasal transcartilaginous incision to reduce the length of the nose. This was followed by stripping of the perichondrium. All incisions were then closed with sutures. Attention was next turned towards correction of the broad alar base. Measurements were made and this was then corrected through a Weir excision procedure. Incisions were again closed with sutures. This resulted in a nasal form that was in perfect harmony with the patient’s facial features. Total patient satisfaction with the results of the cosmetic nasal correction The patient who works in the media was ecstatic over the results of the surgery. She expressed that she now has the nose that she had always desired. Her parents were also very happy with the results of the surgery. She said that she would now be able to concentrate on her profession with a greater level of self confidence. The patient stated that being in the media required being confident about one’s appearance. They expressed their heartfelt gratitude before final discharge from the hospital. Surgery Video width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen">

The patient is a 21-year-old female from Ongole in Andhra Pradesh, India. She was born with a bilateral cleft lip, palate and alveolus defect. There was an oronasal communication through the roof of the mouth.

The patient involved in a head-on car crash while on a work trip The patient is a 26-year-old businessman from Pune in Maharashtra, India. About a year ago, he had driven down to a nearby city for work. While there, he was involved in a head on collision with another automobile. His head had impacted directly on the steering wheel resulting in extensive lower facial injury. He had not been wearing his seatbelt at the time of the accident. He suffered a fractured lower jaw along with fractured teeth in both jaws. An ambulance had been summoned and he was immediately shifted to a nearby hospital. Imaging studies obtained at the hospital revealed bilateral body of the mandible fractures near the premolar region. He had also suffered fractures to maxillary and mandibular anterior teeth. There were no injuries to his eye sockets and bone fractures to other facial structures. This type of injury is very common to unrestrained drivers. They can be life threatening and surgeons with special training are required to address these complex injuries. Complications of malunion and infection with resultant loss of alveolar bone An emergency surgery had been performed and his bilateral mandibular fractures had been stabilized with titanium plates. His fractured anterior teeth were also extracted. Within a month after surgery, it became evident that the surgery had been poorly performed. Bilateral fracture fixation sites developed an infection. This resulted in extensive resorption of the anterior alveolar bone. The height of the alveolus was greatly reduced. Referral to our hospital for management of complications of previous surgery The patient presented at a local hospital for management of his problem. Imaging studies were obtained. The patient was informed that he had suffered from extensive alveolar bone loss secondary to the infection. There was malunion of the fracture repair with infected plates. Postsurgical suturing had been performed poorly with resultant abnormal frenal attachments. The patient and his family were counseled extensively regarding this. It was explained to them that his problem needed to be addressed at a specialty facial trauma care hospital. They were then referred to our hospital for treatment. Anxiety of patient and his family allayed during initial consultation in our hospital Dr SM Balaji, facial trauma care surgeon, examined the patient and ordered imaging studies including a 3D CT scan. There was malunion of the fracture along with reduced alveolar height. This had been caused due to the infection at the fracture site. There was also extensive loss of anterior teeth in both the maxilla and the mandible. Treatment planning explained in detail to the patient and his family It was explained that the patient’s infected titanium plates needed to be removed. This would be followed by reconstruction of the alveolar bone using bone grafts harvested from the patient. Nobel Biocare dental implants would then be placed for rehabilitation of the missing upper anterior teeth. A period of six months would be allowed for bony consolidation of the graft to the alveolar bone. This would be followed by the placement of dental implants for rehabilitation of the missing lower anterior teeth. Ceramic crowns would be placed on the dental implants following complete osseointegration of the implants to the surrounding alveolar bone. The patient and his parents were in complete agreement with the treatment plan and consented to surgery. Successful completion of jaw reconstructive surgery for the patient Under general anesthesia, an inframammary incision was made and a rib graft was harvested. A Valsalva maneuver was then performed to ensure that there was no perforation into the thoracic cavity. Attention was turned to the maxilla where dental implants were placed in the anterior region. This was followed by a mandibular vestibular incision with the removal of the infected plates. The rib graft was then crafted to fit perfectly into the anterior alveolar defect. This was then fixed in place with screws and flaps closed with sutures. Patient expresses understanding of postoperative instructions The patient and his parents expressed their satisfaction with the treatment planning and the surgical results. They stated that they will return in six months for the complete rehabilitation of his oral structures. Surgery Video width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen">

The patient is a 36-year-old man from Satna in Madhya Pradesh, India. He had developed pain and swelling in the molar region of his right lower jaw about six months ago.

The patient is a 19-year-old male from Thanjavur in Tamil Nadu, India. The product of a consanguineous marriage, he was born with a unilateral cleft lip, palate and alveolus deformity.

The patient is a 48-year-old male from Sambalpur in Odisha, India. He has a very strong family history of diabetes on both the paternal and maternal sides of his family.

Cleft Lip Repair Surgery – Modified Millard Technique

Upper jaw Fracture Surgery – Le Fort I Plate Fixation

Wisdom Tooth Removal from Floor of Orbit and Maxillary Sinus

Modified Millard Unilateral Cleft Lip Repair Surgery

Reduction Rhinoplasty – Long Nose Cosmetic Correction

Rhinoplasty and Abbe Flap Reconstruction – Cleft Nose Repair

Lower Jaw Reconstruction with Rib Graft and Dental Implant

Dentigerous Cyst Surgery with Lower Jaw Reconstruction

Unilateral Cleft Deformity – Le Fort I Upper Jaw Advancement

Mandibular Dental Implant Surgery with Alveolar Nerve Protection

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International Patients

Maxillofacial Surgery

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Craniofacial Surgery

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