This gentleman was born with microtia of the right ear. Microtia is the congenital deformity of the external ear. Reconstructive surgery is performed in two stages. He presented to our hospital for surgical correction of his microtia ear deformity. 

A template was first made using the left ear to ensure that the reconstructed right ear was symmetrical to the normal left ear. Costal rib graft with perichondrium was then harvested from the patient. The graft was crafted using the template for reconstruction of the right ear. Markings were made in the region of the deformed right ear and a subcutaneous pocket was created. The crafted cartilaginous graft was placed in the pocket and the incision was closed with sutures.
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The second stage was performed in four months with lifting up of the cartilaginous graft along with placement of a skin graft in the postauricular region. This resulted in reconstruction of a symmetrical right external ear.

This child was born with unilateral macrostomia, which was on the left. There were no other associated structural abnormalities. Her parents presented at our hospital for corrective surgery. Treatment planning was explained to them and they consented to surgery.

The new commissure was marked to ensure postsurgical symmetry with the normal right side. Orbicularis oris was reconstructed using the vermilion return flap. Repair was performed in three layers using the muscles, subcutaneous tissue and skin. This would result in negligible scar formation.

She will now be able to speak clearly and eat without dribbling. Her appearance was also completely normalized with establishment of symmetry. Her parents were very pleased with the results of the surgery.

This baby girl had been born with a unilateral isolated cleft lip deformity. This is the mildest form of cleft deformity, but the most difficult surgery to get best results. Her parents had been counseled at the time of her birth and referred to our hospital.

The nasal sill was addressed using a C-flap. It was then decided to do a three layer closure of her cleft lip deformity. The orbicularis oris, subcutaneous tissues and skin were reapproximated with extreme precision with the use of a surgical loupe. There was perfect recreation of lip anatomy.
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The postoperative picture is at the 7th day after surgery. Her parents were extremely happy with the results of the surgery.

This young girl with hypertelorism was first operated on when she was six years old. Her parents presented with her once she had completed bone growth as instructed at the time of the initial surgery for further corrective surgery. A revision hypertelorism surgery was planned with a box osteotomy and facial bipartition procedure.

Comprehensive studies were obtained preoperatively including axial section CT scans of the facial bones. A mock surgery was then performed on a 3D stereolithographic model of her skull in consultation with the neurosurgical team that was closely involved in each step of the treatment process.

A bicoronal flap was raised and craniotomy was performed after removing previous screws and plates. Extreme care was taken to ensure that there was no damage to the duramater and the traditional frontal bar cut was performed.

Care was taken to preserve the olfactory bulb while handling the crista galli region. The segmental cuts were made with great care and medial nasal part was removed. This was followed by the orbital cut of the box osteotomy, which was performed as planned. Great care was exercised while handling the nasolacrimal duct to ensure that there would be no complications in the future.

The lower cut performed intraorally would result in movement of the midfacial segment alone and not the entire alveolus. After completely mobilizing the midfacial segments and removal of excess tissue, the edges were approximated. The frontal bar served as a standard guide for this procedure. They were secured with plates and screws. The position of external eye and nose were rechecked. Then the incisions were closed in layers.

There was optimal correction of the patient’s hypertelorism following the surgery. She would need a series of further surgeries to complete the rehabilitation process.