This little girl was born with a right-sided hemifacial microsomia with macrostomia. Hemifacial microsomia might be genetic or can be acquired through disruption of in utero vascular supply to the facial region. It is most commonly unilateral.

She had right-sided macrostomia, a short lingual frenum with resultant tongue tie and a prominent right preauricular cartilaginous ear tag.

The short lingual frenum was addressed first. Fibers of the lingual frenum were dissected free and the tongue tie was released. Her right-sided macrostomia was corrected using a vermillion return flap technique. This involved reconstruction of the modiolus on the right side.

The orbicularis oris muscle was first identified and sutured. Buccinator was then identified and sutured. This resulted in a symmetrical reconstruction of the angle of the mouth.

Attention was then turned to the right ear tag. An incision was made and the cartilaginous part of the ear tag was dissected and excised. The incision was then closed resulting in establishment of good facial esthetics for the little girl from the surgery.
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Her parents were extremely satisfied with the results of the surgery.

This young man had suffered a bullet injury to the right infraorbital region, had suffered from extensive injuries including a blow out fracture of the right orbit and had undergone extensive reconstruction in the first stage of surgical correction of his deformities.

He now presents for second stage surgery for correction of resorption of infraorbital fat, ectropion deformity and excessive scleral show of his right eye. Treatment planning was explained to him and he consented to surgery.

A subdermal fat graft was harvested and tunneled into the infraorbital region for reestablishment of symmetry. He then underwent superior repositioning of his lateral canthal ligament with correction of his ectropion and excessive scleral show.

He was very happy with the results of the surgery.

This little girl had a congenital bilateral cleft lip and palate deformity. Her parents were counseled regarding her cleft deformities at the time of her birth.

She was brought to our hospital for surgical correction when she was 8 months old. Her bilateral cleft lip deformity was addressed first. She had a very wide cleft with a mobile premaxilla. Her prolabium was also very tiny along with a very short columella. There was also very minimal tissue for reconstructing the lip.
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She underwent a single stage repair utilizing Paul Black’s technique. No cross incision was made at the prolabium. Available prolabium and columella were utilized for reconstructing the philtral column and Cupid’s bow.

This was followed by creation of the nasal floor and vermillion. Bilateral C-flaps were utilized for this. Extreme care was taken as there was very minimal tissue available. This was followed by meticulous three layer closure of the cleft lip under loupe magnification. Orbicularis oris muscle was approximated at the midline. This was followed by approximation of the subcutaneous tissue and skin.
Her parents were extremely happy with the results of the surgery.

This little boy had incomplete bilateral cleft lip and palate deformity. This was very mild. His parents were extensively counseled regarding the management of his deformity and sent to our hospital for corrective surgery.

His bilateral cleft lip deformity was addressed first. At the age of 3 months, he underwent a single stage repair utilizing Paul Black’s technique. No cross incision was made at the prolabium. Available prolabium and columella were utilized for reconstructing the philtral column and Cupid’s bow.

This was followed by creation of the nasal floor and vermillion. Bilateral C-flaps were utilized for this. This was followed by meticulous three layer closure of the cleft lip under loupe magnification. Orbicularis oris muscle was approximated at the midline. This was followed by approximation of the subcutaneous tissue and skin.
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Her parents were extremely happy with the results of the surgery.