Removal of Distractor after Facial Asymmetry Correction and Advancement Genioplasty
This young girl had suffered trauma to her jaw with resultant unilateral TMJ ankylosis and mandibular deviation to the left side
Unilateral Cleft Lip and Palate Deformity
This little boy was born with a unilateral cleft lip and palate. His parents had been very distressed by his facial deformity. They were referred to our hospital for cleft lip surgery when he was 3 months of age.
Unilateral Cleft Lip and Palate with Wide Gap and Very Small Minor Segment
[et_pb_section fb_built=”1″ _builder_version=”4.6.5″ _module_preset=”default”][et_pb_row _builder_version=”4.6.5″ _module_preset=”default”][et_pb_column type=”4_4″ _builder_version=”4.6.5″ _module_preset=”default”][et_pb_text _builder_version=”4.6.5″ _module_preset=”default”] Little Girl born with Unilateral Cleft Lip and Palate Deformity This 3-month-old little girl is from Tenali in Andhra Pradesh, India. She was born with a very wide unilateral cleft lip and palate defect. There was a hole in the roof of the mouth. Upper lip and nose were a part of this deformity. Alignment of permanent teeth in the cleft region is often affected. Lateral incisors can also be absent. Reconstructive surgery culminates with the placement of dental implants. Board certified cosmetic surgeons perform these surgeries in the west. This is the second most common birth defect in infants. Her parents were stoic about this and sought guidance about its management. Children with clefts get to lead normal lives with adequate surgical correction. Parents Conduct Research for Best Cleft Hospital in India They researched in-depth about the best cleft hospital in India. This led them to meet many facial cosmetic surgeons and facial plastic surgeons. They enrolled in many cleft support groups and traveled for counseling. Convinced by the extensive research, they presented to our hospital for management. Causes and Research into Occurrence of Cleft Deformities The etiology of cleft lip and palate defect is very varied. It can arise due to genetic, environmental factors or mutation. Many mothers with cleft deformity give birth to babies with similar presentation. Sources of heavy electromagnetic radiation are another alleged cause in recent years. Research is ongoing into this and there is no proof yet about this connection. Center for Cleft Lip and Palate Correction in India Our hospital is a specialty center for cleft lip and palate surgery. We are a nodal referral center for facial deformity surgery in Asia. Many patients have had facial esthetics restored through our facial trauma surgery. We have over 30 years experience in cleft lip surgery and cleft palate surgery. Patients from all over the world come for facial cosmetic surgery. Recognition from International Organizations Our hospital is an affiliate of the World Craniofacial Foundation of USA. Our hospital has won awards from the International Cleft Lip and Palate Foundation. Many complex craniofacial cleft patients referred by these organisations undergo treatment with us. There is minimal scarring from surgery due to surgical innovations adopted by us. Initial Presentation and Treatment Planning at our Hospital Dr SM Balaji, Cleft Lip Surgeon, examined the patient in detail. The minor segment was very low and not visualized. This increased the degree of difficulty. He explained that the ideal time for cleft lip surgery was 3 months. Cleft palate surgery was at 11 months and cleft alveolus bone grafting at 3-1/2 years of age. The parents of the girl then signed the consent for cleft lip surgery. Surgical Correction of Cleft Lip Defect A modified Millard’s technique was the technique of choice for surgery. Scarring is less compared to other techniques. Functional and esthetic results are also better with this technique. An ambidextrous approach is the optimal technique for best results in this surgery. Our hospital is a pioneer for this approach in India. Minimal Postoperative Scarring Following Surgery This surgery, the first in April, was at the height of the Covid-19 pandemic. Dr SM Balaji donned a protective suit with a separate oxygen supply. This suit ensured the surgeon’s comfort throughout the surgery. It utilized a two fan system. One fan was to blow out exhaled air and the other fan was to bring in fresh oxygen-rich air. All safety precautions were to ensure the protection of patients and other OT personnel. The surgeon remains enclosed within the suit throughout the procedure. Optimal Results from Cleft Lip Surgery A C flap was first raised to recreate the nasal sill followed by an M flap to create the floor of nose. Optimal tissue usage ensured that there was no tissue wastage. There was good adaptation of the two halves of the cleft lip. Results were optimal despite the difficult presentation. Her parents were very happy with the results of the surgery. Postoperative scarring was very minimal by the time of discharge from the hospital. Cleft palate repair will be at the age of 11 months. [/et_pb_text][et_pb_text _builder_version=”4.6.5″ _module_preset=”default” hover_enabled=”0″ sticky_enabled=”0″] Video [/et_pb_text][et_pb_video _builder_version=”4.6.5″ _module_preset=”default” src=”https://youtu.be/SwKITeod7Ls” hover_enabled=”0″ sticky_enabled=”0″][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Upper Jaw Bone Defect – Reconstruction with Rib Graft
The patient is a 24-year-old female from Nanguneri in Tamil Nadu, India. Over a period of two years, she had begun to notice a slow growing swelling in the maxillary right incisor region.
Upper Jaw Reconstruction with Rib Graft and Dental Implants
The patient is a 28-year-old male from Pune in Maharashtra, India. He is an entrepreneur with his own startup company. Around 12 years ago, he had been injured while playing hockey in school.
Cleft Lip Repair Surgery – Modified Millard Technique
[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]
Upper jaw Fracture Surgery – Le Fort I Plate Fixation
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,
Wisdom Tooth Removal from Floor of Orbit and Maxillary Sinus
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.
Modified Millard Unilateral Cleft Lip Repair Surgery
[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]
Reduction Rhinoplasty – Long Nose Cosmetic Correction
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