A 22-year-old man reported to our hospital seeking to correct the appearance of his nose. His nose was much flat in the middle portion and he wanted to have a sharp nose to improve his appearance.
Maxillofacial surgeon Dr. S. M. Balaji expertly performed the augmentation rhinoplasty. A costochondral cartilage graft was harvested and used to reconstruct the depressed dorsum of the nose. Defined tip of the nose was achieved by removing the excessively curved portion of lower lateral nasal septal cartilage. The surgery was done from inside the nose (closed rhinoplasty) so there is no scarring. The patient is very happy to have a sharp, defined & pristine nose immediately after surgery, which improved his appearance. 

22 year old female, a known case of bilateral TMJ ankylosis reported to our hospital for the surgical correction of lower half of the face. Micrognathic mandible present due to retarded development. She gave the history of TMJ ankylosis release surgery done elsewhere during childhood.
After thorough clinical and radiological examination Maxillofacial Surgeon Dr. S. M. Balaji planned to correct the facial asymmetry using internal distraction osteogenesis with maxillomandibular distractor. Bilaterally Paragingival incision was placed over the angle region along the anterior border of ramus. Full thickness mucoperiostal flap was reflected buccally and bone exposed. The direction of the osteotomy cut and positioning of the distractor is the most important as it determines the vector of distraction and this determines the direction of the bone growth. The distractor device was positioned and fixed using screws. Osteotomy is then completed along the medial cortex. Distractor device was checked and wound closure done. Le Fort I osteotomy was completed in maxilla.
After a latency period of 5 days, distraction at the rate of 1 mm per day was accomplished and facial asymmetry was successfully corrected. Thus maxillomandibular distraction technique helped dramatically to enhance the facial appearance without any visible scars and taking autobone graft anywhere from the body. Patient feels very happy to have enhanced facial appearance without any scar on the face.

A 22-year-old girl came to our hospital wanting to correct the shape of her nose to improve her appearance. She was born with cleft lip and palate for which she was treated elsewhere in her childhood. Now her nose appeared asymmetric, misshapen & flattened and the nostrils appeared collapsed, which made her look unattractive. She was very depressed about her facial appearance.
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Maxillofacial Surgeon Dr. S.M. Balaji performed the cleft rhinoplasty to correct the nose shape. Rib graft was taken and used to raise the base of the nose through an intraoral approach. Also the height of the columella was increased and the graft was used to reconstruct the alae and nasal dorsum. Immediately following surgery the nose appeared sharp, symmetrical and pristine greatly improving her appearance. The girl is very happy to have an attractive look without any scar.

A 28 year old man from Nigeria came to our hospital for expert treatment for his lower jaw defect. He gave the history of surgical removal of cystic lesion which was histopathologically diagnosed as follicular cyst in his lower jaw twice in his hometown and reconstructed with Bio-oss synthetic bone protein. Recurrence of the cystic lesion noted and the swelling was initially small and gradually increased to its present size for a period of 5 months. He was worried for the recurrence and wants to have permanent solution for the same.
Maxillofacial Surgeon Dr. S.M. Balaji performed the clinical and radiological investigations. OPG and 3D CT scan showed a large radiolucent lesion extending from the lower left first molar teeth till right first premolar region. Almost entire bone in this portion of the lower jaw was lost.
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Dr. Balaji successfully removed the cyst completely along with the affected teeth and bone. Rib graft was harvested and the used to reconstruct the jaw bone defect & the surgical site was closed. After subsequent healing, implants & ceramic crowns will be placed for fixed replacement of lost teeth.

A 3-month-old baby girl born with unilateral cleft lip and palate was brought to our hospital by her parents for specialized treatment of the defect.
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Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the primary cleft lip repair using modified Millard’s technique.  Right away after surgery the baby’s appearance was extraordinary improved and she was able to feed well. Her parents were very happy to have the cleft lip surgically treated with negligible scar. After few months cleft palate repair will be done.

A 4-month-old baby girl born with unilateral cleft lip and palate was brought to our hospital by her parents for specialized treatment of the defect.
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Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the primary cleft lip repair using modified Millard’s technique.  Right away after surgery the baby’s appearance was extraordinary improved and she was able to feed well. Her parents were very happy to have the cleft lip surgically treated with negligible scar. After few months cleft palate repair will be done.

A 3-month-old baby girl born with bilateral cleft lip and palate was brought to our hospital by her parents for specialized cleft lip & palate surgery.
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Maxillofacial Surgeon Dr. S.M. Balaji performed the primary cleft lip correction surgery using Paul Black’s technique to reconstruct the lip enabling the baby to feed well while also dramatically enhancing the baby’s appearance.  Subsequent cleft palate surgery will be done to completely rehabilitate the child. 

A 55 year old patient reported to our hospital with a large, bony swelling in the anterior portion of the lower jaw (mandible). He had said that the swelling had gradually increased in size over the past 1 year and there was spontaneous loss of few lower teeth over the last 6 months. He also reported of altered sensation in the lower lip for past 3 weeks which was his main concern.
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 A 3D CT scan was taken to gauge the extent of the lesion. A biopsy was done which showed the lesion to be a multiple cystic ameloblastoma (tumor) of the lower jaw. Maxillofacial Surgeon Dr. S. M. Balaji removed the entire bony tumor along with the involved bone and reconstructed the defective portion of mandible using the native bone itself without any bone graft by following advanced transport guided distraction osteogenesis technique.

The entire affected portion of the lower jaw was ressected with 1.5 cm marginal clearance followed by reconstruction using titanium plate guided bilateral tripod multi docking complex univector Herford plate guided mandibular transport distractor.

After 5 days of latency period, the distractors were activated at a rate of 0.5mm twice per day (on both sides) until the transport discs had reached the canine region on both sides (amount of distraction on the right side was 46mm and on the left 43.2mm). Following consolidation period of 3 months and radiological evidence of corticalization, the distractors were removed. And complete dental implant rehabilitation done for lower arch in the newly formed healthy bone. Cosmetically well blended fixed ceramic prosthesis given.

A 24 year old girl reported to our hospital seeking cosmetic correction of her nose. She had undergone nose correction operation elsewhere to correct her crooked nose shape and blocked nose but they had used open rhinoplasty technique which resulted in an unsightly scar. She was not at all satisfied with the results. She felt the dorsal surface of her nose was flat which gave her an aged look. She wanted to correct her nose profile cosmetically.
Maxillofacial Surgeon Dr. S. M. Balaji planned to correct her flattened nose by following closed augmentation rhinoplasty. Costochondral rib graft was harvested which was used to augment the dorsum of nose. To prevent scarring, the graft was inserted through intranasal approach. Enlarged turbinates were also trimmed. Results are immediate, patient is very happy to have a sharp, pristine nose without any surgical marks, which suits her facial profile. Also she is happy that she no longer has blockage of the nose and can breathe easily.

A 25-year-old American came to our hospital seeking a fixed replacement for his missing teeth. He gave a history of having had multiple impacted teeth which were extracted before, elsewhere. Subsequently there was severe deficiency of bone in his upper & lower jaw due to which he was refused fixed teeth there.
A 3D CBCT scan taken revealed severely atrophied maxillary & mandibular bone. Maxillofacial Surgeon & Implantologist successfully performed the jaw bone reconstruction and dental implant replacement for his missing teeth in two stage procedure. Rib graft was harvested & used to reconstruct the thin upper & lower jaw bone.

After complete jaw reconstruction, dental implants were fixed in the reinforced regions of the maxilla & mandible. Following complete osseointegration of the implants with the surrounding bone, teeth prosthesis was fixed. The man is very happy to have fixed replacement of his missing teeth and to get back his confident, pleasing smile that remarkably improves his appearance.

An 18 year old girl from Bangladesh was brought to our hospital by her parents for expert treatment for her lower jaw defect. The girl complained of a intermittent pain and swelling in the left side of her lower jaw. The swelling was initially small and gradually increased to its present size for a period of 3 months. The parents were very worried about their daughter’s health.
Maxillofacial Surgeon Dr. S.M. Balaji performed the clinical and radiological investigations. OPG and 3D CT scan showed a large radiolucent lesion extending from the lower left first premolar to second molar teeth involving impacted third molar. Almost entire bone in this portion of the lower jaw was lost. A biopsy of the lesion proved to be odontogenic keratocyst.
Dr. Balaji successfully removed the cyst completely along with the affected bone and teeth. Rib graft was harvested and the used to reconstruct the jaw bone defect & the surgical site was closed. After subsequent healing, implants & ceramic crowns will be placed for fixed replacement of lost teeth

A 30-year-old man from Bangladesh was suffering from severe pain and swelling in his right side of lower jaw. He also complained of difficulty to open his mouth wide and bite and chew foods. He was advised by his family doctor in his home town to go to Balaji Dental and Craniofacial Hospital at Chennai, India, for specialized treatment.
Maxillofacial Surgeon Dr. S.M. Balaji thoroughly evaluated his jaw defect clinically and using advanced 3D CT scan. The scan images showed that he had multiple and extensive areas of bone loss that appeared to resemble large cystic tumors involving the almost entire right side of lower jaw.
Biopsy of the lesion was done which proved it to be odontogenic keratocysts. Dr. Balaji planned a complete reconstruction of the lower jaw right side, using the man’s own rib graft. The affected portion of the lower jaw bone was surgically removed. Diseased portions of the bone were completely and thoroughly removed to ensure that there is no recurrence. A costochondral cartilage graft (rib graft) was taken and used to reconstruct the lower law. Following a few months time, rehabilitation will be completed with implants and ceramic prosthesis. The man feels very happy for the surgery outcome and the entire surgery was done intraorally avoiding external scar formation.   

A 25-year-old American came to our hospital seeking a fixed replacement for his missing teeth. He gave a history of having had multiple impacted teeth which were extracted before, elsewhere. Subsequently there was severe deficiency of bone in his upper & lower jaw due to which he was refused fixed teeth there.
A 3D CBCT scan taken revealed severely atrophied maxillary & mandibular bone. Maxillofacial Surgeon & Implantologist successfully performed the jaw bone reconstruction and dental implant replacement for his missing teeth in two stage procedure. Rib graft was harvested & used to reconstruct the thin upper & lower jaw bone.

After complete jaw reconstruction, dental implants were fixed in the reinforced regions of the maxilla & mandible. Following complete osseointegration of the implants with the surrounding bone, teeth prosthesis was fixed. The man is very happy to have fixed replacement of his missing teeth and to get back his confident, pleasing smile that remarkably improves his appearance.

32 year old American women reported to our hospital seeking to correct the shape of her nose. Her nose was disproportionately large and which affected her appearance. She sought to enhance the appearance of her nose for a more pleasing look.
Maxillofacial surgeon Dr. S.M. Balaji successfully performed the reduction rhinoplasty using closed rhinoplasty technique to reduce the size of the nasal framework. Intranasally, bulky tip of the nose was reduced by removing the caudal portion of nasal septal cartilage and asymmetrical nostrils were corrected by removing the footplate of medial crus on the left side. Lateral and medial osteotomy was done to reduce the width of the nose. The surgery was done from inside the nose to avoid scarring. Immediately following surgery the nose appeared proportionate greatly enhancing the facial appearance.

A 26-year-old man came to our hospital seeking to correct the shape of his nose to enhance his appearance. His nose was very large and bulbous.
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Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the reduction rhinoplasty to correct the nose shape. Lateral osteotomy was done and lower lateral nasal septal cartilage was removed to reduce the bulky nose and decrease the size of the nose tip. Weir excision was done to narrow the wide nostrils. Immediately following surgery the reshaped nose greatly enhanced his appearance and he is very happy that the procedure was done without visible scars.

A 25-year-old man came to my hospital after he sustained injuries to his face in a road traffic accident. After immediate first aid, he complained of pain in the left side of lower jaw and inability to bite properly.
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A 3D CT scan taken showed a fracture in the left mandibular condylar base and right parasymphyseal fracture. This caused a derangement in the patient’s occlusion or contact between upper and lower teeth on the right side due to condyle fracture leading to vertical shortening of the mandible on the left side. Maxillofacial Surgeon Dr. S.M. Balaji performed the surgical fracture reduction. The fracture site was surgically exposed, the patient’s occlusion was accurately restored, the fractured segments were stabilized and fixed in their normal position with titanium bone plates and the open bite was corrected.

A 35 year old lady from Assam came to our hospital seeking for surgical correction of her facial swelling. She described that she previously had surgical removal of the lower jaw swelling extraorally at her hometown few years back. Now it has recurred and she wants to have permanent solution for the same.
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After thorough clinical, radiological and histopathological examination, Maxillofacial Surgeon Dr. S. M. Balaji diagnosed it as fibrous dysplasia involving the entire left body, angle and ramus of the mandible. Also there was an impacted mandibular left 3rdmolar in the coronoid process of mandible. Under General Anesthesia, intraorally bony excess was removed from both buccal and lingual surface of mandible and impacted tooth was also removed in toto.  Thus entire bony swelling was removed and patient feels very happy to have the entire procedure done without any scars on the face. 

25 year old man reported to our hospital seeking for cosmetic correction of his right ear defect. He consulted many plastic surgeons for the surgical correction but was not satisfied.
On examination, the helix of the right ear was defective. Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected his ear defect using wedge closure technique without much visible scars. Results are immediate. He is very happy to have single stage ear defect correction. 

A 26-year-old girl reported to our hospital seeking to correct the appearance of her nose. Her nose was much flattened from the middle. And she wanted to have a sharp nose with defined tip to improve her appearance.
Maxillofacial surgeon Dr. S. M. Balaji expertly performed the augmentation rhinoplasty. A costochondral cartilage graft was obtained and used to reconstruct the depressed, collapsed dorsum of the nose following medial and lateral osteotomy. Bulbous and drooping tip of the nose was corrected by removing the lower lateral nasal septal cartilage. The surgery was done from inside the nose (closed rhinoplasty) so there was no scarring. The patient feels very happy to have a sharp, defined & pristine nose immediately after surgery, which improved her appearance. 

A 3 month old baby girl was born with unilateral incomplete cleft lip. Her parents brought her to our hospital for surgical management.
Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the cleft lip repair using modified Millard’s technique. Following suture removal 7 days after surgery, the baby’s appearance was greatly enhanced. The baby’s parents were very happy to have the cleft lip defect corrected with very negligible scar.

A 22-year-old girl came to our hospital with her parents for expert correction of her cleft nose & lip defect to enhance her appearance. Her nose was flattened and collapsed on the left side and there was an unsightly scar on the lip which affected her appearance. She was previously operated elsewhere for her unilateral cleft lip and palate in her childhood.
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Maxillofacial Surgeon Dr. S. M. Balaji successfully performed the cleft rhinoplasty & cleft lip revision. Intranasally lower lateral nasal septal cartilage was removed. The surgery was done from inside the nose so there were no scars. Secondary cleft lip revision was also done and missing left upper lateral incisor tooth was replaced with dental implant. Immediately following surgery, the girl’s appearance improved greatly and she was very happy with the surgery outcome. 

A 20-year-old girl reported to our hospital seeking to correct the shape of her external ear. Due to excess cartilage the ear helix appeared bulky and enlarged and it appeared asymmetrical. She was not happy with the appearance of the ear shape and wanted to correct it surgically.
Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the ear correction surgery. The excess ear cartilage was surgically trimmed & excess skin tissue was cut. The sutures were placed behind the ear so that there is no visible scar.  Immediately following surgery the ear appeared more balanced in shape & size and symmetry was achieved. The girl is very happy to improve her appearance without any scar.

A 3 month old baby girl was born with unilateral incomplete cleft lip. Her parents brought her to our hospital for surgical management.
Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the cleft lip repair using modified Millard’s technique. Following suture removal 7 days after surgery, the baby’s appearance was greatly enhanced. The baby’s parents were very happy to have the cleft lip defect corrected with very negligible scar.

28 year old women reported to our hospital seeking to correct the shape of her nose and jaw. Her nose was disproportionately large and which affected her appearance and her jaw was prominent with retruded chin.  She sought to enhance the appearance of her face for a more pleasing look.
Maxillofacial surgeon Dr. S. M. Balaji successfully performed the reduction rhinoplasty using closed rhinoplasty technique to reduce the size of the nasal framework. Intranasally, bulky tip of the nose was reduced by removing the caudal portion of nasal septal cartilage. Lateral osteotomy was done to reduce the width of the nose. Everted tip of the nose was corrected by augmenting the dorsum of the nose using the cartilage obtained from the lateral nasal septal cartilage. The surgery was done from inside the nose to avoid scarring. Intraorally mandibular setback done and chin advancement done using advancement genioplasty. Immediately following surgery the nose appeared proportionate greatly enhancing the facial appearance.