Depressed Nose Augmentation Rhinoplasty Surgery
Young lady desiring surgical correction presents to hospital This young lady is from Madurai. She had always desired a sharp nose. Desiring surgical correction, her family had searched for the best nose correction surgeon. This led them straight to our hospital. Examination of the nose with detailed treatment planning Dr SM Balaji examined the patient and recommended costochondral graft placement. This would raise the bridge of the nose and give the patient’s nose a sharp profile. The patient was in agreement with this treatment plan. Harvesting of costochondral rib graft from the patient Under general anesthesia, a costochondral graft was first harvested from the patient. A Valsalva maneuver demonstrated absence of perforation into the thoracic cavity. Following this, the incision was then sutured in layers. Surgical augmentation of a depressed bridge of the nose Attention was then turned to the nose. All incisions were intranasal to avoid scar formation. The costochondral graft was then crafted to the right size. This was then tunneled to the bridge of the nose and stabilized with sutures. The patient now had a sharp nose with a straight bridge. The patient expressed her happiness at the results of the surgery before discharge.
Fibrous Dysplasia Bulk Reduction Surgery
Young boy presents with fibrous dysplasia This young boy is from Nellore. He has the diagnosis of fibrous dysplasia. Fibrous dysplasia is a disorder of the bone where fibrous tissue develops in place of bone. This weakens bone and can lead to fractures. The patient has this swelling straddling his nose and extending on both sides. His parents brought him to our hospital for reduction of the fibrous tissue. A local dentist referred them here for cosmetic surgery. Patient examined and treatment plan explained in detail Dr SM Balaji examined the patient and ordered radiographic studies. Diagnosis was confirmed as fibrous dysplasia. He explained the treatment planning to the parents who agreed to the surgery. Surgery for fibrous dysplasia done with good esthetic results A vestibular incision was first made in the anterior maxillary region. Dissection was then done down to the fibrous tissue overlying the nasal region. The fibrous tissue was burred and trimmed until attaining normal facial anatomy. Incision was then closed with sutures. The patient and his parents expressed their satisfaction before final discharge.
Dentigerous Cyst -Simple Enucleation Surgery
Boy with swelling referred to our hospital for treatment The patient is a little boy from Vadodara. He had complained of a swelling in his left jaw. His parents took him to a local dentist. The dentist suspected this to be a dentigerous cyst. He then referred them to our hospital for management. Dentigerous cyst confirmed and treatment plan explained Dr SM Balaji examined the patient and ordered a 3D CT. This revealed a dentigerous cyst with an impacted second molar within it. He advised surgical removal of the cyst and the parents agreed. Dentigerous cyst enucleated without any complications Under general anesthesia, a mucogingivoperiosteal flap was first raised. This exposed the bony swelling enclosing the dentigerous cyst. The cyst was then enucleated and removed. Following this, the flap was then sutured back into position. The patient recovered without event from the surgery
Macrostomia, Tongue tie and Ear tags, extra Ear Lobule Correction Surgery
A long drawn search for the best facial cosmetic surgeon for this child This 5-year-old girl from Itarsi was born with a mouth that was very wide on the right side. The medical term for this condition is macrostomia. Her macrostomia and hemifacial microsomia resulted in underdevelopment of her right face. There may be absence of external ear in this condition. Ear tags may be present. The ear tags may contain cartilaginous tissue. If so, they need to be first dissected, repaired and sutured back. This child will need several surgeries later for reconstruction of the lower jaw. Macrostomia correction is first done and the ear tags removal is then done. She needs complete follow up of growth of mandible on the right side. She also had a tongue tie and ear tags with an extra lobe of the right ear. The tongue tie was causing abnormal speech patterns in the child. Her parents had searched far and wide for the best facial deformity surgeon to correct this. Their search had been futile for many years. It was only around six months ago that they met the parents of a similar child. Surgery performed for that child at our hospital had resulted in perfect correction. This led the parents of this little girl straight to our hospital. Treatment plan explained to the parents Dr SM Balaji examined this little girl and ordered diagnostic studies. He explained the proposed surgical plan to her parents. They were in complete agreement with his treatment plan. This was the first stage of surgical correction for this little girl. Tongue tie and macrostomia correction surgery Under general anesthesia, the tongue tie was first addressed. The lingual frenum was then dissected free to enable full extension of the tongue. This would enable normal speech for the child. Attention was next turned to the macrostomia correction. The vermillion border on the right side was first dissected. The excess tissue was then removed. The vermillion border was then sutured to ensure symmetry of the lips. Ear tag and extra ear lobe removal surgery Attention was then directed to the ear tags and extra ear lobe on the right. The ear tags were first dissected free and excised. The extra ear lobe was also addressed in similar fashion with good esthetic results. Suturing of all incisions completed the surgical procedure. The patient’s parents expressed their complete satisfaction with the results before discharge. Surgery Video
Facial asymmetry correction- condylar hyperplasia already operated but failed, maxillary shortening, buccal fat pad transfer, malar and mandibular body augmentation surgery
Patient with failed surgery elsewhere presents for correction The patient is a young woman with failed condylar hyperplasia surgery performed elsewhere. She presented to our hospital for correctional surgery. Dr SM Balaji examined the patient and ordered detailed studies for the patient. Rib graft and buccal fat pad graft obtained from the patient Under general anesthesia, a rib graft was first harvested from the patient. Valsalva maneuver demonstrated a patent thoracic cavity. The incision was then closed with sutures. This was next followed by harvesting of a buccal fat pad graft from the right cheek. Augmentation of the mandibular body done with grafts A left sided maxillary vestibular incision was next made. The bone grafts were then shaped and fixed with screws in this region. Attention was next turned to the mandible. A mucogingivoperiosteal flap was then raised. The bone grafts were then screwed in place in the molar region. This led to adequate augmentation of the body of the mandible. Maxillary repositioning and buccal fat pad transfer performed Attention was next turned to the anterior maxillary region. An osteotomy was then performed and the maxilla repositioned with four holed plates. This was then followed by transfer of the buccal fat pad graft to the left cheek. All incisions were then closed with sutures. The patient expressed complete satisfaction with the results of the surgery before discharge. Surgery Video
Large dentigerous cyst of maxilla enucleated. Root canal treated teeth saved and defect filled with rib graft
Young boy with dentigerous cyst presents with nonvital teeth The patient is a young boy who presented with a swelling in the left anterior maxilla. Dr SM Balaji examined the patient. The teeth in the area of the swelling were nonvital. Radiograph revealed the presence of a large dentigerous cyst in that region. Treatment planning was for surgical excision of the cyst. Dentigerous cyst enucleated and teeth saved A mucogingivoperiosteal flap was first raised in the anterior maxillary region. There was a supernumerary tooth present within the dentigerous cyst. The dentigerous cyst was then enucleated and removed with care taken to save all RCT teeth. A rib graft was then harvested to fill in the bony defect. Valsalva maneuver demonstrated lack of perforation into the thoracic cavity. Bony defect filled with harvested rib graft The harvested rib graft was then cut and shaped to fit into the bony defect. The graft was then fixed with screws. The flap was then sutured back in place. Postoperative healing was uneventful. Surgery Video
Short lip correction Le Fort I impaction superior positioning surgery
Patient with prognathic maxilla and short upper lip presents for surgery This young man presented with a vertical excess of the prognathic maxilla. It resulted in the shortening of the upper lip with inability to appose the lips. This was causing social problems for the patient. He presented to our hospital for surgical correction of his problem. Treatment planning explained to the patient Dr SM Balaji examined the patient and ordered imaging studies. On cephalometric analysis, it was found that he had 7 mm vertical excess of maxillary bone. He explained the treatment plan to the patient who agreed to it. Successful Le Fort I surgery with optimal results for the patient Under general anesthesia, a Le Fort I maxillary osteotomy was performed initially. The maxilla was then disengaged from the facial bone. A 7 mm strip of maxillary bone was removed in the horizontal plane. The disengaged maxilla was then repositioned superiorly with two X-plates and screws. Occlusion was then checked and found to be perfect. The incision was then closed with sutures. The patient expressed his complete satisfaction at the results of the surgery. Surgery Video
Profile enhancement by correction of upper jaw using AMO
A 25-year-old male from Raipur reported to our hospital wanting to correct his gummy smile. He also stated that his protruding upper jaw affected his appearance. He had low self-esteem and complained of inability to close his mouth. He also wanted to enhance his looks. His parents too were anxious to correct his smile and enhance his facial appearance. Maxillofacial Surgeon Dr. SM. Balaji planned for removal of the maxillary bone. The gummy smile was corrected by Anterior Maxillary Osteotomy. Post surgery his appearance improved greatly and his parents were happy with the immediate results. He was overjoyed with the outcome as he was able to close his mouth without any difficulty.
Successful closure of alveolar cleft defect with bone graft
12 year old with cleft alveolus brought for surgical repair The parents of this 12-year-old boy brought him to our hospital. They are from northern India. He had been born with a cleft lip, palate and alveolus. He had already undergone cleft lip and palate repair elsewhere as an infant. The alveolar cleft was a very large one. This caused the parents to be very concerned about their son’s present condition. They decided to turn to the Internet for a solution. A search for the best cleft aleveolus repair surgeon led them straight to our hospital. Treatment plan presented followed by successful surgery Cleft alveolus repair specialist, Dr SM Balaji decided on the treatment plan. He planned to close the defect with a bone graft. The cleft was first packed with costochondral bone graft and fixed using screws. Successful outcome of the treatment process for the patient After three months, the maxilla will fuse into one single bone. Replacement of missing teeth and orthodontic treatment will then achieve completion of treatment. The parents were very happy with the outcome of the surgery.
Neurofibroma debulking surgery
Neurofibroma explained to be an inherited disorder Neurofibroma is a benign tumor of the nerve sheath. It arises from the peripheral nervous system. An inherited disorder, is very disfiguring and adds bulk to the affected tissues. It always results in asymmetry of the affected region. Young man with neurofibroma presents for surgery This is a young man from Thalassery. He has had this debilitating condition since childhood. His face is only affected on the right side. The right eye had also become blinded by this condition. He has undergone previous surgery elsewhere in the past for the tissue overgrowth. He has become reclusive and withdrawn because of this. The growth has recurred again to the point it interfere with his activities of daily living. His family conducted extensive enquiries with medical professionals for the best cosmetic surgeon. These enquiries led them straight to our hospital for management of his disfigurement. He will need another surgery to correct his lower lip disfigurement. The patient examined and treatment plan explained Dr SM Balaji examined the patient and explained the treatment plan. The patient was in agreement with this. Surgery is done with removal of overgrowth of excess fibrous tissue Under general anesthesia, excess neurofibromatous tissue was first retracted and then excised. The proliferation of this tissue in the lobule of his right external ear was also trimmed. This resulted in the improvement of the patient’s facial contour. After removal of adequate tissue, the incisions were then closed with sutures. The patient expressed satisfaction in the improvement of quality of life before discharge.