Facial Asymmetry Correction with Fat Graft for Parry Romberg Disease
This patient first noticed a developing asymmetry due to gradual atrophy of his left lower jaw a few years back and had been diagnosed with Parry Romberg disease
Fibrous Dysplasia of Zygoma and Orbit
[et_pb_section fb_built=”1″ _builder_version=”4.9.4″ _module_preset=”default”][et_pb_row _builder_version=”4.9.4″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.4″ _module_preset=”default”][et_pb_text _builder_version=”4.9.4″ _module_preset=”default”] Young Man Notices Gradual Development of Facial Asymmetry The patient is a 26-year-old man from Thalassery in Kerala, India. He has had a slowly progressing facial asymmetry for many years now. There was a gradually developing swelling of the right midfacial region. A biopsy had been obtained and he had been diagnosed with fibrous dysplasia. He had chosen to ignore it as it was not causing him any functional difficulties. Disfigurement caused by Fibrous Dysplasia and its Probable Etiology Fibrous dysplasia is a rare disorder of the bone where normal bone is replaced by fibrous tissue. There is an overgrowth of this fibrous tissue, which results in progressive facial disfigurement. The bone is also weakened by this fibrous tissue. It is thought to result from a genetic mutation at birth but is not hereditary. There is a dull ache in the region of the affected bone. Fractures are also common when it affects the limb bones. The only treatment available is the surgical removal of the fibrous tissue. Patient Decides to Undergo Surgical Correction of his Deformity The growth has now progressed to the point where it is causing self-esteem problems for the patient. He was beginning to avoid social interactions because of the extreme facial disfigurement. His parents researched the internet for the best hospital to get this addressed. They also made widespread inquiries regarding the same. Our hospital is a premiere center for facial plastic surgery in India. Many patients have undergone facial cosmetic surgery and facial reconstructive surgery at our hospital. He and his parents zeroed in on our hospital for his fibrous dysplasia surgery. Our hospital stringently follows protocols laid down by the American Society of Plastic Surgeons. We also conform to the guidelines laid down by the European Society of Aesthetic Plastic Surgery. Many referrals are made from centers in the European Union to our hospital for correction of facial deformities. Patients from around the world come to us for reconstructive plastic surgery and facial asymmetry surgery. We utilize advanced facial biometric systems for facial asymmetry correction. Facial implants can be utilized when there is a bony deficiency causing facial asymmetry. Initial Consultation and Treatment Planning at our Hospital Dr. SM Balaji, facial cosmetic surgery, examined the patient and spoke with him at length. Biopsies and imaging studies were ordered including CT scans. This revealed a diagnosis of fibrous dysplasia of zygoma and orbit along with the involvement of the temporal bone. The fibrous overgrowth had caused gross disfigurement of both bones. Our hospital also offers comprehensive imaging services including magnetic resonance imaging (MRI) scan and bone scan. He explained the surgical treatment process and the cosmetic improvement to the patient. All queries raised by the patient and his family were addressed. The patient and his parents expressed understanding and consented to surgery. A 3D stereolithographic model of the patient’s skull was obtained. The fibrous overgrowth was studied and presurgical analyses were performed. It was then decided to proceed with surgery. Surgical Removal of Fibrous Overgrowth The affected regions of the zygoma and temporal bone were approached through a hemicoronal incision. No other approach would enable satisfactory removal of the fibrous tissue. Surgery progressed through dissection of the galea and temporal fascia. Care was taken to also preserve blood supply to the temporalis muscle to prevent any postsurgical atrophy. The frontalis and orbicularis oculi branches of the facial nerve were protected throughout the surgical procedure. Dysplastic fibrous overgrowth was removed meticulously. Normal bony contour was established through the removal of the excess tissue. This would restore symmetry to his face. The fascia was sutured with retraction of the temporal muscle after adequate removal. This was to ensure that there would not be a hollowed-out appearance to the region. The incision was finally closed with staples. Postsurgical Improvement in Facial Appearance The patient and his parents were very happy with the results of the surgery. There was a tremendous improvement in the cosmetic appearance of the face. Improvement in the patient’s self-confidence was apparent shortly after surgery. He and his parents expressed their total satisfaction with the treatment process at our hospital. Surgery Video [/et_pb_text][et_pb_video src=”https://youtu.be/A4e0AFHj1AA” _builder_version=”4.9.4″ _module_preset=”default”][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Orbital Dystopia Surgery with Medial Canthopexy and Rhinoplasty
[et_pb_section fb_built=”1″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_row _builder_version=”4.9.2″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_text _builder_version=”4.9.2″ _module_preset=”default”] Orbital Dystopia Surgery One of the most common clinical symptoms of craniofacial malformation is orbital dystopia. The concept dystopia refers to the orbits’ mono- and bilateral asymmetry in at least one of the three-dimensional planes. The clinical examination of the patient is used to make the diagnosis, which is supported by diagnostic instruments such as teleradiography in both normal projections, axial computed tomographic (CT) scans at a rate of 1:1 via the neuro-orbital plan, and three-dimensional CT. A young man with Grievous Facial Injuries from Road Traffic Accident This is a 24-year-old man from Ranchi in Jharkhand, India. He had been involved in a horrific road accident. There was also blindness caused by the loss of his left globe. This had resulted in left-sided facial fractures involving his middle facial region. These fractures involved many bones causing asymmetry. There was the involvement of his orbital bone, nasal bone, zygoma and maxilla. He had undergone a series of surgeries in various hospitals. These had left him with a facial asymmetry and severe orbital dystopia. He descended into a depression because of the turn of these events. His worried parents had consulted far and wide for the best hospital to address his problems. They were referred to our hospital by a leading plastic surgeon in their hometown. They contacted our hospital manager and fixed an appointment for a consultation. Board-certified facial cosmetic surgeons perform these surgeries in Western nations. Oral and Maxillofacial surgeons who are also cosmetic surgeons perform these in India. Leading Center for Facial Trauma Surgery In India Our hospital is a leading center for redo facial trauma surgery in India. Many patients with complications arising from surgery performed elsewhere present to our hospital. Our hospital serves as a tertiary referral center for craniofacial surgery in Asia. We are a specialty center for prosthetic eyeball surgery in India. Our in-house prosthetic laboratory provides custom-made shells to many centers around the country. Specialty Center for Redo Facial Cosmetic Surgery Dr SM Balaji, facial cosmetic surgeon, examined the patient and obtained imaging studies. The patient had gross facial asymmetry. This was caused by the malunion of the facial fractures. There was a widening of the canthal bay due to the nasoorbitoethmoidal fracture. He also had a depressed nose due to a fracture of the nasal bone. CT scans were also obtained for the evaluation of the cribriform plate. Treatment planning was presented to the patient and he consented to surgery. Facial Asymmetry Correction Performed in our Hospital A costal cartilage graft was first harvested to augment the depressed nose. The sites of the malunited fractures were then accessed. The plates from the previous surgeries were also removed. A Titanium mesh with Medpor was then introduced through the subconjunctival incision. This resulted in the reconstruction of the fractured orbital floor. A lateral canthopexy was then performed for the correction of the canthal bay deformity. This was next followed by augmentation rhinoplasty. The costal cartilage graft was used to raise the bridge of the flat nose. This resulted in the correction of his nasal deformity. An orbital conformer was then placed at the conclusion of the surgery. This resulted in the correction of his facial deformities. The patient expressed his satisfaction with the results of the surgery. His parents too conveyed their gratitude before final discharge from the hospital. Surgery Video [/et_pb_text][et_pb_video src=”https://youtu.be/dgOxpYSD2QI” _builder_version=”4.9.2″ _module_preset=”default”][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Facial Paralysis Surgery – Static Suspension
[et_pb_section fb_built=”1″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_row _builder_version=”4.9.2″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_text _builder_version=”4.9.2″ _module_preset=”default” hover_enabled=”0″ sticky_enabled=”0″] Facial Paralysis Surgery in India What is Facial Paralysis? Bell’s palsy can be caused by a viral infection. It almost never happens more than once.Bell’s palsy is described by muscle weakness, which causes one-half of the face to droop.Bell’s palsy normally goes away on its own after six months. Physiotherapy can help prevent muscles from contracting indefinitely. Patient with Facial Paralysis seeks Solution for his Problem The patient is a 27-year-old male from Rourkela in Odisha, India. He has had long-standing facial paralysis on the right side of his face. There was a drooping of the corner of the mouth on the affected side. He had tried a variety of medical treatments, which failed to address his problem. Referral to our Hospital for Treatment of his Condition This had left him feeling very frustrated. Seeking a solution, he had visited a cosmetic surgeon in his hometown. He underwent a dynamic reanimation with temporalis reanimation surgery. There was no improvement in his facial paralysis and this surgery was a complete failure. An internet search for the best facial paralysis surgery hospital in India had brought up our name. Having satisfied himself with the search results, he contacted our hospital manager and fixed an appointment for an initial consultation. Specialty Center for Facial Cosmetic Surgery in India We are a leading center for facial paralysis surgery in India. Our hospital is well known for facial plastic surgery in India. We are a specialty center for the correction of drooping mouth. This most commonly is caused by facial paralysis. We offer advanced treatments with the latest innovations from around the world. The cost of lip paralysis surgery in India is a fraction of what it costs in the West. Board-certified plastic surgeons often perform these surgeries in Europe and Japan. Regaining Movement in Paralyzed Face Facial reanimation surgery is also performed in our hospital. Patients come from around the world for this surgery. The patient regains the ability to emote following this surgery. Surgery for Correction of Facial Deformities Many conditions lead to facial asymmetry. The asymmetry can either be isolated to the soft tissue like in facial paralysis. It can also be due to underlying bony deformities. Facial palsy is caused by loss of innervation to facial muscles on one side supplied by the facial nerve. Viral infections are a frequent cause of facial palsy (Bell’s palsy), but a majority of such cases recover spontaneously. We also specialize in facial asymmetry surgery. Scores of patients have been rehabilitated after undergoing surgery in our hospital. Initial Consultation at our Hospital Dr. SM Balaji, facial cosmetic surgeon, examined the patient. He obtained a detailed history and spoke with the patient at length. Treatment planning was discussed with the patient. The mechanism of static suspension surgery was explained to him. He was encouraged to ask questions and clear his doubts. Once all his questions were answered to his fullest satisfaction, he expressed understanding and consented to undergo surgery. Successful Cosmetic Rehabilitation of Facial Paralysis Surgery commenced with harvesting a fascia lata graft from the thigh. The incision was closed with sutures once the graft was harvested. Attention was next turned to the face. An elliptical incision was made over the nasolabial fold. Orbicularis oris muscle fibers were then identified. The fascia graft was tunneled up to the zygomatic arch. The graft was then looped around the arch to form a circumzygomatic sling. Care was taken to ensure that there was no damage to any nerves or vessels. Both ends of the fascia lata sling were then sutured to the orbicularis oris. There was a good improvement of facial symmetry following this procedure. A lateral tarsorrhaphy was also performed as his cornea was getting ulcerated due to his inability to oppose the left eye. Total Patient Satisfaction with Results of Surgery The patient was very happy with the results of the surgery. He expressed his gratitude to the surgical team before discharge from the hospital. Surgery Video [/et_pb_text][et_pb_video _builder_version=”4.9.2″ _module_preset=”default” src=”https://youtu.be/BjVnhd8E8GM” hover_enabled=”0″ sticky_enabled=”0″][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Facial Asymmetry Correction by BSSO Surgery
[et_pb_section fb_built=”1″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_row _builder_version=”4.9.2″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.2″ _module_preset=”default”][et_pb_text _builder_version=”4.9.2″ _module_preset=”default”] Facial Asymmetry Surgery by bilateral sagittal split osteotomy (BSSO) Patient with a Progressive Increase in Lower Jaw Size The patient is a 21-year-old male from Durgapur in West Bengal, India. He has always had a very large lower jaw in comparison to his upper jaw. There was also a slight deviation of the lower jaw to the right. This resulted in a mild asymmetry of his lower face. A bilateral sagittal split osteotomy (BSSO) is the surgery of choice for reducing a large lower jaw. A receded lower jaw is advanced using distraction osteogenesis. Internal distraction is safer and preferred over external distraction. The open bite caused by upper jaw abnormalities is corrected through maxillary osteotomy. Size discrepancy between the jaws can lead to a lot of functional difficulties. Speech is altered and eating patterns are also altered. Left unaddressed, this could possibly also lead to problems with the temporomandibular joint (TMJ). Cosmetic compromise is another important aspect that could lead to issues with self-esteem and self-confidence. Associated Difficulties Caused by his Jaw Asymmetry He has also faced speech and eating difficulties throughout his life. Of note, his brother also has a large lower jaw. He had presented to a surgeon in his hometown. Realizing that this was a complicated presentation, he was referred to us for surgery for jaw and chin correction. The mechanism behind Perception of Jaw Size Discrepancy The disparity in jaw size is a common cause of facial deformity and asymmetry. Either the lower jaw or the upper jaw can be larger than the other jaw. This could be a result of either a large jaw or a small jaw. A small upper jaw could make a normal lower jaw appear large. Correction of this deformity could either be through jaw reduction or jaw augmentation. Le Fort I maxillary setback reduces the size of a large upper jaw. Bilateral sagittal split osteotomy reduces the size of a large lower jaw. An increase in the size of the lower jaw is through distraction osteogenesis. Le Fort I osteotomy is the technique of choice for upper jaw advancement. Jaw reconstructive surgery helps correct a variety of deformities, both congenital and acquired. Facial plastic surgeons also perform these surgeries in Japan and other developed countries. Initial Presentation for Jaw Correction Surgery at our Hospital Dr. SM Balaji, facial asymmetry surgery specialist, examined the patient. The patient had mandibular prognathism as well as lower facial asymmetry. Treatment planning was formulated and explained to the patient. He was in agreement and consented to jaw reduction surgery. Specialty Surgical Procedures Performed at our Hospital Our hospital is a specialty center for facial cosmetic surgery. Facial plastic surgery in our hospital has transformed many lives. Scar revision surgery for burn scars is performed through tissue expansion. We are a specialty center for cosmetic nose surgery in India. Successful Surgical Correction of Jaw Deformity Bilateral bone cuts were first made in the mandible. The nerve was safely mobilized with the distal segment. This allowed for free manipulation of the proximal segment. Extreme care was taken to preserve the inferior alveolar nerve during surgery. A slice of bone 14mm in thickness was removed from the left side. This was followed by a smaller slice of 12 mm being removed from the right to set right the asymmetry. Occlusion was checked and was found to be normal. The mandible was then stabilized with plates and screws. His facial appearance was transformed following the surgery. He was very happy with the results of the surgery. His family thanked the surgical team before discharge from the hospital. 5 Points on Facial Asymmetry Surgery – Facial Cosmetic Surgery A Minor Degree of Facial Asymmetry is Completely Normal Both sides of the face are near mirror images though it is never a perfect match. There is a minor degree of facial asymmetry even in normal faces. This is how nature works. There is never perfect symmetry of the face or the body. It is this minor asymmetry that adds to the attractiveness of the individual. This asymmetry is however not evident to common people. Purely Cosmetic Deformity Versus Function Affecting Deformity It is only when this degree of asymmetry is present to a degree where it is clearly noticeable that it becomes a problem that needs to be addressed. There are two components to the problems caused by this. One is pure cosmetic where it is only the appearance that is affected and not the function. The second is when normal function is affected by the asymmetry. Procedures for Cosmetic Facial Asymmetry Correction Procedures like cosmetic rhinoplasty help correct minor imperfections in the face and enhance the appearance of the individual. Many high visibility celebrities undergo such procedures to enhance their facial features for greater career opportunities. Facial asymmetry normally manifests itself early in life whether it is idiopathic or caused by a medical condition like hemifacial microsomia. Injuries or infections to the developing baby during pregnancy can also result in facial disfigurement. It can however occur at any stage in life too as a result of trauma or diseases like cancer. Facial asymmetry is very distressing to the affected individual and leads to associated psychological effects like depression and becoming introverted with self-isolation. Struggles of Mankind through the Ages for Restoring Normal Facial Appearance Mankind has tried to address this over the ages through various means. For example, World War I was the first truly global war that led to unprecedented levels of facial mutilation. A special unit was created to help individuals who suffered from facial asymmetry due to injuries sustained in war. Facial Plastic Surgery developed rapidly through the efforts of such units. The Development of Modern Surgical Techniques Modern surgery has come a long way in addressing the issue of facial asymmetry. Oral and Maxillofacial Surgery as well as Craniofacial Surgery deal extensively with the correction of facial asymmetry and restoration of normal facial
OPEN VS CLOSED RHINOPLASTY WHICH TECHNIQUE IS BEST?
[et_pb_section fb_built=”1″ admin_label=”section” _builder_version=”3.22″][et_pb_row admin_label=”row” _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.9.2″ _module_preset=”default” hover_enabled=”0″ sticky_enabled=”0″] OPEN VS CLOSED RHINOPLASTY : WHICH TECHNIQUE IS BEST? RHINOPLASTY AS A LIFESTYLE CHOICE TO ENHANCE QUALITY OF LIFE Open vs Closed Rhinoplasty: Undergoing a nose correction surgery or a nose job is often a life-changing experience for an individual. A rhinoplasty can change a person’s life for the better or the worse. Many show-biz celebrities from around the world have seen their careers soar or collapse as a result of a rhinoplasty. NEED FOR EXTENSIVE PRESURGICAL COUNSELING REGARDING EXPECTATIONS Individuals who present for a cosmetic rhinoplasty have certain expectations about the results. It is imperative that they discuss these expectations in detail with the surgeon during the treatment planning phase itself. TYPES OF RHINOPLASTY FOR NASAL DEFORMITY CORRECTION There are two types of rhinoplasty procedures, namely open rhinoplasty and closed rhinoplasty. Open rhinoplasty involves making an incision in the soft tissue between the two nostrils. This allows for easy access to the bony and the cartilaginous parts of the nose. Closed rhinoplasty involves making incisions inside the nose. INDICATIONS FOR CLOSED AND OPEN RHINOPLASTY Extreme deformities of the nose are addressed through open rhinoplasty. An open rhinoplasty allows for greater manipulation of the structures that give form to the nose. Lesser deformities of the nose are addressed through closed rhinoplasty. There is minor visible scarring from an open rhinoplasty. There is no scar formation in a closed rhinoplasty as all incisions are made inside the nose. The recovery period is longer in open rhinoplasty with more postoperative swelling when compared to closed rhinoplasty. This is due to the greater degree of corrections performed through open rhinoplasty. IMPORTANCE OF EXPERIENCE OF SURGEON IN COSMETIC NOSE SURGERY Certain cases that have a complicated presentation can be addressed only through open rhinoplasty. Closed rhinoplasty cannot be performed for the correction of deformities in these cases; however, a vast majority of nasal deformities can be set right through closed rhinoplasty. Surgeons with greater experience can correct even large deformities through a closed rhinoplasty while these corrections are approached through an open rhinoplasty by lesser experienced surgeons. The average cost for open rhinoplasty is Rs 2,00, 000 and the average cost for closed rhinoplasty is Rs 1,50, 000. [/et_pb_text][et_pb_text _builder_version=”4.9.2″ _module_preset=”default” custom_margin=”||0px||false|false” custom_padding=”||0px||false|false” hover_enabled=”0″ sticky_enabled=”0″] Closed Rhinoplasty with Nasal Augmentation – Cleft Lip Deformity Patient born with a unilateral cleft lip and palate deformity The patient is a 20-year-old female from Palakkad in Kerala, India. She had been born with a right-sided cleft lip and palate deformity. Her parents had been extensively counseled on the management of an infant with a cleft deformity. They had been referred to a nearby city for surgical management of her cleft deformity. She had subsequently undergone cleft lip repair at 3 months of age and cleft palate repair at 11 months. A plastic surgeon had performed these surgeries. The patient had subsequently developed speech difficulties for which she had undergone pharyngoplasty. Bone graft surgery is needed if there is a large cleft alveolus deformity. Worsening nasal defects with the passage of time As the patient grew up, her nasal deformities worsened. She had a nose that was flattened and asymmetrical. This was a direct result of the collapse of her columella. Her right alar region was also depressed due to a bony defect. Cleft nasal deformities involve both bone and cartilage. They are the most common form of birth defects. There was prominent scarring from the cleft lip repair surgery. The patient felt that this detracted from her facial esthetics. It was explained to her that a scar revision surgery can be scheduled at a later date to address that. Surgery for correcting her nasal deformities done elsewhere The patient had first undergone cosmetic rhinoplasty (nose job) at the age of 14. This was to correct her severely depressed nose, which was also asymmetrical. Multiple cartilage grafts had been harvested and used in this corrective surgery. She had however not been happy with the end results of the surgery. A couple of years later, she had undergone a redo rhinoplasty at a different hospital. The old grafts had been removed and replaced with new grafts. This had however worsened the appearance of her nose. She does not require open rhinoplasty. Her nasal deviation had become worse and she developed a whistling sound while breathing. Her alar base depression had not been addressed by either surgery. The patient feeling despondent and depressed as a result of the two failed surgeries Feeling extremely upset by the turn of events, she had slowly become depressed and withdrawn. Her academic performance had also become affected by this. Always a good student, she had become indifferent towards her studies. Alarmed by this, her parents decided to get this addressed to the patient’s satisfaction. Her parents made widespread enquiries and visited a score of surgical centers over the ensuing months. They got in touch with our hospital manager and sent the patient’s photographs for analysis. Convinced that our hospital was the ideal place for this surgery, they decided to come for a consultation. Premier center for cosmetic rhinoplasty and cleft rhinoplasty correction We have been addressing patients with nasal deformities for three decades now. Every variety of nasal deformity correction is performed at our hospital. Our hospital is world renowned for cleft rhinoplasty correction. We have won accolades from the International Cleft Lip and Palate Foundation of Japan. The World Craniofacial Foundation of USA has made us its Southeast Asian regional affiliate. Initial presentation at our hospital for detailed consultation and treatment planning Dr. SM Balaji, nasal cosmetic surgeon, examined the patient and obtained a detailed history and imaging studies. The patient-related her dissatisfaction with the results of the two previous surgeries. She had a severely depressed nose that was asymmetrical. There was resorption of the grafts that had been previously placed for nasal augmentation. The patient’s nose also had extensive transcolummelar intranasal scar formation from
Distractor Removal after Le Fort III Bone Consolidation
[et_pb_section fb_built=”1″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_row _builder_version=”4.9.0″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_text _builder_version=”4.9.0″ _module_preset=”default” hover_enabled=”0″ sticky_enabled=”0″] What is Maxillary distraction osteogenesis? Maxillary distraction osteogenesis is a surgical technique that prolongs the lower jaw and forces the tongue forward to widen the airway and corrects these problems. Traditionally, babies with this disorder have been treated by tracheostomy, which continues for many years before the infant develops the condition. Patient born with the classical presentation of Crouzon syndrome deformities The patient is a 24-year-old female from Manapparai in Tamil Nadu, India. She was born with the abnormal facial features of Crouzon syndrome. Genetic testing is done soon after birth confirmed the diagnosis. Crouzon syndrome is caused by a genetic defect that leads to craniostenosis. There is the premature fusion of skull bones in this condition. This leads to the development of deformities of the face and skull. Manifestation of Crouzon syndrome with bony orbital and midfacial deformities This patient had most of the classical signs of Crouzon syndrome. She had protuberant eyeballs because of deficiency of the orbital bones. There was also a marked regression of the midfacial region. Strabismus was another classical sign that was seen in this patient along with a beaked nose. Difficulty childhood due to the extreme degree of facial defects in the patient She had faced a significant degree of bullying at school. Her parents had therefore decided to homeschool her for a majority of her school years. This limited social contact had resulted in her having very few friends. She had always been socially withdrawn and introverted. Her parents were counseled by a plastic surgeon that she needed surgical correction of her deformities. They had made extensive enquiries regarding the best hospital to address her needs. A social organization that helps patients with facial deformities had referred them to us. Premier center for craniofacial deformity correction in India Our hospital is a renowned center for facial deformity surgery in India. We deal with deformities that are both congenital and acquired in nature. Our center is a specialty center for facial trauma surgery in India. Only a few surgeons in India have the experience required to perform complex craniofacial procedures. Many patients with congenital facial defects arising from syndromic craniostenosis have been successfully treated in our hospital. Distraction surgery is routinely performed here. Facial bones are brought into perfect alignment through craniofacial surgery. Initial presentation for of syndromic facial deformity surgery in our hospital Dr. SM Balaji, syndromic craniofacial deformity surgeon, examined the patient. Imaging studies including 3D CT scans were ordered for the patient. He also obtained a 3D stereolithographic model of the patient’s skull. She had all the classical signs including protruding eyeballs, a beaked nose and midfacial retrusion. He explained that the patient needed midfacial Le Fort III advancement surgery along with internal distraction. A Kawamoto distractor device would be utilized for this. This was due to the extreme degree of midfacial retrusion. The patient subsequently underwent surgical correction of her deformities. A bicoronal flap was raised followed by bony cuts to the zygoma. The lower part of the orbital bone was then cut for 180 degrees next. This allowed for dysfunction of the bone. Kawamoto distractors were then fixed and checked with trial distraction. Her frontal prominence was also reduced through the use of a burr. The bicoronal flaps were closed. Maxillary Distraction osteogenesis commenced after the latency period. A total of 15 mm of distraction was performed. There was a complete correction of her midfacial retrusion along with strabismus. This would normalize her eyesight. Total patient satisfaction with the results of the surgery They were ecstatic with the results of the surgery. She could see things clearly now and there was a marked improvement in facial esthetics. Her parents were instructed to bring her back in four months for internal distractor removal surgery. This period would allow for bony consolidation at the site of distraction. Patient returns for removal of internal distractors after four months The patient and her parents returned for distractor removal surgery. After obtaining imaging studies, the patient was scheduled for distractor surgery. A bicoronal flap was raised and the distractor was removed by unscrewing the screws. Flap was closed using skin staples. Her skin staples were removed following the complete healing of the incision wound. They were instructed to return in four month’s time for a checkup. She and her parents expressed their complete satisfaction with the results. They thanked the surgical team before discharge from the hospital. [/et_pb_text][et_pb_text _builder_version=”4.9.0″ _module_preset=”default” custom_margin=”0px||0px||false|false” custom_padding=”0px||0px||false|false”] Surgery Video [/et_pb_text][et_pb_video src=”https://youtu.be/mI1QSubWcTI” _builder_version=”4.9.0″ _module_preset=”default”][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Jaw Joint Fracture – TMJ Surgery
[et_pb_section fb_built=”1″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_row _builder_version=”4.9.0″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_text _builder_version=”4.9.0″ _module_preset=”default”] What is Jaw Joint Fracture (Temporomandibular Joint (TMJ) fracture) Jaw Joint Fracture or temporomandibular joint (TMJ) factor occurs when the mandible and/or temporal bone is broken near or through the TMJ, the joint linking the jaw bone to the skull. Like other bones in the body, the mandible, also known as the jaw bone, and the temporal bone, the bone on the skull that forms the upper part of the jaw joint, can break when trauma occurs. Fractures of TMJ arise due to direct trauma to the face. The jaw splits most frequently around the condyles, which are rounded projections of the jaw bone. The fracture can also occur when the joints are dislocated. Young Boy suffers Jaw Injury from Fall at Home The patient is an 11-year-old boy from Chennai in Tamil Nadu, India. He tripped and fell while playing with friends a few hours ago. His lower jaw hit the ground and he complained of inability to open his mouth fully. There was also mild bleeding from a lower lip laceration. His parents noticed a deviation of his jaw to the left side upon mouth opening. There was also a grating noise from the left jaw joint. He also complained of facial pain on the left side. There was radiation of pain from his jaw joint to the rest of the face. Development of facial asymmetry is a feature found in all fractures of the jaws. Movement of the jaw results in worsening of the pain. Initial Consultation at our Hospital for Management Fearing that he had a fracture, his parents rushed him to our hospital. Our hospital is a leading center for jaw fracture surgery in India. We are a specialty treatment center for jaw joint fractures. Our hospital has introduced various innovations related to jaw surgery. These innovations are standard operating procedures in many parts of the world today. Features of Jaw Surgeries Performed at our Hospital. Various conditions of the jaws are addressed at our hospital. Jaw reduction surgery and jaw augmentation surgery are also performed at our hospital. Upper jaw augmentation is commonly through Le Fort I maxillary osteotomy. Lower jaw augmentation is through distraction osteogenesis. Jaw reconstruction is also performed for lesions like tumors and cysts. Our hospital specializes in all types of TMJ surgery. Bone grafts harvested from the patient aid in the reconstruction of jaw deformities. These are most commonly harvested from the ribs and iliac crest. All these surgeries are performed under general anesthesia. Joint reduction surgery is performed after ensuring all safety precautions. Special safety features have been added in view of the COVID-19 pandemic. Lower jaw fractures are amongst the most common fractures. Common causes are accidents and assaults. The lower jaw most commonly strikes the ground first when there is a fall. Upper jaw fractures are more associated with assaults and road traffic accidents. They rarely occur from falls. Children constitute a high proportion of patients with jaw fractures. This is due to their very active lifestyle and physical activity. Forces are transmitted from the chin to the jaw joint. The chin and the jaw joint are the most common sites for lower jaw fracture. This can be treated by either open reduction or closed reduction. Closed reduction is utilized in children and in the case of favorable fractures. Open reduction is the preferred choice of treatment in more complex presentations. Examination and Treatment Planning for the Patient Dr. SM Balaji, facial cosmetic surgeon, examined the patient and obtained imaging studies. Lower lip laceration was sutured and a diagnosis of left temporomandibular joint condylar fracture was made. There was a medial displacement of the fractured condyle. This presentation necessitated plate fixation for fracture stabilization. Treatment planning was explained to the parents and they consented to surgery. Successful Reduction and Fixation of Condylar Fracture The fracture site was approached through a modified Alkayat-Bramley incision using an endaural approach. The fractured condylar segment was visualized and stabilized using plate and screws. Extreme care was taken to ensure the safety of the facial nerve. There will be no visible scar tissue from the surgery. Movement of the mandible after plate fixation demonstrated good fracture reduction. The patient recovered without an event from the surgery. He demonstrated good facial nerve function and there were no deficits. He opened his eyes and closed them forcefully as well as demonstrated normal mouth opening. They were very happy with the level of care at our hospital and expressed total satisfaction. He and his parents thanked the hospital staff before final discharge from the hospital. [/et_pb_text][et_pb_text _builder_version=”4.9.0″ _module_preset=”default” hover_enabled=”0″ sticky_enabled=”0″ custom_margin=”||0px||false|false” custom_padding=”||0px||false|false”] Surgery Video – Jaw Joint Fracture Surgery [/et_pb_text][et_pb_video _builder_version=”4.9.0″ _module_preset=”default” src=”https://youtu.be/Cygn5VtxmbQ” hover_enabled=”0″ sticky_enabled=”0″][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Fronto orbital Complex Fracture Surgery (Eye level Correction)
[et_pb_section fb_built=”1″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_row _builder_version=”4.9.0″ _module_preset=”default” custom_margin=”||0px||false|false” custom_padding=”||0px||false|false”][et_pb_column type=”4_4″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_text _builder_version=”4.9.0″ _module_preset=”default” text_font_size=”16px”] Patient Involved in Road Traffic Accident in his Hometown The patient is a 46-year-old man from Ajmer in Rajasthan, India. He had been injured in a multi-vehicle road accident around six months ago. There was a direct impact on the left side of his face from a vehicular bonnet. He had suffered multiple fractures to the bones of the left upper and middle face. Orbital blowout fractures are common in such accidents. There were also serious soft tissue injuries. Failed Surgery at a Multispecialty Hospital He had been rushed to a multispecialty hospital in a nearby town for emergent care and treatment. This had been followed by a series of surgeries to correct his deformities. All these surgeries failed and he was left with a gross left-sided facial deformity. There was also malocclusion from the failed surgeries. Feeling very frustrated, he had approached an organization for help to address this. Having referred patients to us before for facial cosmetic surgery, they sent him to us. They contacted our hospital manager and set up an appointment for him. Our hospital is a specialty center for redo facial trauma surgery of failed surgeries performed elsewhere. Board-certified plastic and reconstructive surgeons perform such complex surgeries in Western nations. We rehabilitate patients who need complex head and neck surgery Initial Presentation at our Hospital for Redo Facial Trauma Surgery Dr. SM Balaji, facial reconstruction surgeon, examined him and obtained a detailed history. A 3D CT scan revealed malunion of his facial fractures from botched surgery. There was malpositioning of the medial wall of orbit fracture. He also had malunion of his frontozygomatic and front orbital fractures. His left frontal bone had a depressed fracture. Extraocular muscle movement was hampered by the circumorbital fractures. Multiple Fractures of the Left Facial Region There was also a blowout fracture of the left floor of the orbit. This had resulted in the lowering of his left orbital contents in relation to the right. A poorly positioned mesh was visualized over his left frontal bone. Malunion of his zygomaticomaxillary fracture had resulted in severe malocclusion. His speech was also affected by his condition. It was explained to him that all the old plates needed to be removed. The malunited fractures had to be refractured and replated in the correct anatomical position. The patient was in agreement with the plan and consented to surgery. Refracture of Multiple Malunited Fractures from Previous Surgeries Access was gained to the left forehead fracture site through the old incision. Plates from previous surgeries were removed. There was a very poor reduction of the front orbital and frontozygomatic fractures. Resetting Fracture Segments in Correct Anatomical Position Fracture segments were aligned in normal anatomical positions. The old mesh was also removed. Granulation tissue was excised from the region and bone smoothened with a bur. The old plates from the zygomaticomaxillary fracture fixation were removed. Occlusion was adjusted and the fracture fragments were stabilized with plates. His old zygomatic arch fracture was also stabilized with plates and screws. It had been unstable after the previous surgery. This was then followed by a subciliary incision. Access was gained to the orbital floor blowout fracture site. Entrapped orbital contents were released. The medial wall of orbit fracture was addressed next. The detached canthal ligament was reattached with a Y-plate canthopexy. This resulted in a good correction of the fracture. Next, a titanium mesh with Medpor was used to repair the orbital floor fracture. This resulted in eye-level correction for the patient. A new mesh was then placed over the depressed frontal bone fracture. Total Patient Satisfaction with Results of Surgery The surgery resulted in improved facial esthetics as well as functional improvements. The patient tolerated the procedure well. He expressed his gratitude to the surgical team before discharge from the hospital. [/et_pb_text][/et_pb_column][/et_pb_row][et_pb_row _builder_version=”4.9.0″ _module_preset=”default” custom_margin=”0px||0px||false|false” custom_padding=”0px||0px||false|false”][et_pb_column type=”4_4″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_text _builder_version=”4.9.0″ _module_preset=”default”] Surgery Video [/et_pb_text][et_pb_video _builder_version=”4.9.0″ _module_preset=”default” src=”https://youtu.be/J7GVkGLIuDQ” hover_enabled=”0″ sticky_enabled=”0″][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Pierre Robin Syndrome – Lip Adhesion Release Surgery
[et_pb_section fb_built=”1″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_row _builder_version=”4.9.0″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.9.0″ _module_preset=”default”][et_pb_text _builder_version=”4.9.0″ _module_preset=”default” text_font_size=”16px” hover_enabled=”0″ custom_margin=”||0px||false|false” custom_padding=”||0px||false|false” sticky_enabled=”0″] What is Pierre Robin Syndrome? Pierre Robin syndrome is a disorder in which an infant has a smaller than normal lower jaw, a tongue that falls back in the throat, and breathing difficulties. Causes The exact causes of the Pierre Robin Syndrome are unknown. It is likely a part of a variety of genetic syndromes. The lower jaw grows slowly before birth but can grow faster in the first few years of life. Symptoms Symptoms of this condition include: Cleft palate High-arched palate Jaw that is very small with a small chin Jaw that is far back in the throat Repeated ear infections Small opening in the roof of the mouth, which may cause choking or liquids coming back out through the nose Teeth that appear when the baby is born Tongue that is large compared to the jaw Patient Returns for Tongue Lip Adhesion Reversal This 10-month-old boy is from Chennai in Tamil Nadu, India. He was born with the classical signs of Pierre Robin syndrome. There were micrognathia, retruded tongue and cleft palate. Children with cleft palate have a hole in the roof of the mouth. His parents presented to our hospital for management of his birth deformities. Treatment planning was first explained to the parents. They understood each surgery had to follow the planned schedule for the best results. Parents consented to the proposed treatment plan. Plastic surgeons also perform this surgery in countries like Japan and the US. Retruded tongue position and micrognathia cause the tongue to fall into the throat. This would result in airway blockage by the tongue. He underwent tongue lip adhesion surgery a day after the presentation at our hospital. This surgery prevents the occurrence of stridor in Pierre Robin afflicted infants. Characteristics of Airway Obstruction by Tongue Stridor is the high-pitched breath sound arising from an obstructed airway. Infants with Pierre Robin sequence run the risk of airway obstruction by the tongue. Tongue lip adhesion surgery prevents this potential threat to the life of the infant. Pierre Robin syndrome can develop from an abnormal intrauterine fetal neck position. Flexion of the developing mandible against the sternoclavicular joint can result in micrognathia. This could cause abnormal retrusion of the tongue. The tongue pushes up against the developing palate causing nonfusion of the palate. This syndrome can also have a genetic basis for its development. Specialty Center for Management of Cleft Deformities Dr. SM Balaji, Oral and Maxillofacial Surgeon, has over 30 years of surgical experience. This includes cleft lip and palate surgery and craniofacial deformity surgery amongst others. Our hospital is also a specialty center for facial cosmetic surgery. Many celebrities have undergone cosmetic nose surgery at our hospital. We are also a specialty trauma care center for facial fracture surgery. Our hospital also has a 24-hour ambulance service for facial trauma victims. Our hospital is the Southeast Asian affiliate of the Dallas-based World Craniofacial Foundation. Students from Western dental schools request our hospital for observership opportunities. Many children with syndromic deformities get a new lease of life at our hospital. Patients from all over the world come to our hospital to undergo corrective surgery. These include patients from developed regions like Europe, Japan and the US. We have two dedicated states of art operating theaters in our hospital. Our nursing staff has over 20 years of experience in providing quality postoperative care. The lives of many afflicted children have undergone transformation here. Cleft Palate Surgery followed by Tongue Release The patient underwent cleft palate repair at 10 months old. A positive suction test denoted that there was optimal surgical correction. He then underwent reversal of the tongue lip adhesion in two days. Delay of this surgery would lead to abnormal speech development. There was an uneventful recovery from both surgeries. He was very lively and vocal throughout his postoperative stay. Tongue movement demonstrated the full range of motion. His parents were very happy with the results of the surgery. They expressed their gratitude to the hospital staff before final discharge. [/et_pb_text][et_pb_text _builder_version=”4.9.0″ _module_preset=”default” hover_enabled=”0″ sticky_enabled=”0″ custom_margin=”0px||0px||false|false” custom_padding=”0px||0px||false|false”] Surgery Video [/et_pb_text][et_pb_video _builder_version=”4.9.0″ _module_preset=”default” src=”https://youtu.be/RCPbTpu8SFs” hover_enabled=”0″ sticky_enabled=”0″][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]