A 30 year old man reported to our hospital wanting to correct his nose profile which was very broad and flat to his face. He also wanted to correct his nose tip which was ill-defined that gave him more aged appearance. Due to his defective nose profile he was very self conscious about his appearance.

Maxillofacial Surgeon Dr. S. M. Balaji skillfully planned to correct his nose by following Augmentation Rhinoplasty technique with alar base correction. Costochondral graft was harvested from the ribs, shaped and used to reconstruct the nose to increase the height. Thus proper shape of the nose was achieved. Alar base was corrected with Weir excision and the nostrils were made defined and symmetrical. Entire nose correction was made within the nose (closed rhinoplasty technique); there are no scars on the face. Results are immediate and the patient was very happy to see his enhanced profile of the nose without any scars. This dramatically improved his appearance and self confidence. 

A 6 year old boy with bilateral cleft lip and palate was brought to our hospital with the complaints of escape of food and water to the nose while eating and slurred speech due to escape of  air to the nose through the hole in the teeth bearing region of the upper jaw. Primary cleft lip and palate repair was done elsewhere.

After thorough clinical and radiographic examination Maxillofacial Surgeon Dr. S. M. Balaji diagnosed that in the previous cleft surgery the Surgeon has removed the premaxilla completely along with the developing tooth buds. Thus a part of alveolus along with the few teeth was missing which led to huge cleft defect in the midline of the upper jaw bone.  Dr. Balaji skillfully planned to close the cleft alveolar defect with the miracle protein rhBMP-2.

A gingivomucoperiosteal flap was raised and the cleft defect was exposed and miracle protein rhBMP-2 was placed in the alveolar cleft defect region and the flap was approximated with sutures. This protein helps the body’s own cells to form new bone at the site of placement. After 3 months achieving complete union of the segmented alveolar bone into a single complete maxilla, replacement of missing teeth followed by orthodontic treatment will be planned. 

A 25 year old man reported to our hospital seeking to correct his protruding lower jaw. This gave him an aged appearance and he was not happy with his facial profile.

Maxillofacial Surgeon Dr. S. M. Balaji expertly planned to correct his lower jaw protrusion by using bilateral sagittal split osteotomy technique (Obwegeser sagittal Split osteotomy). Intraorally a cut was made bilaterally in the lower jaw bone in the mandibular ramus region and the bone was set back to its correct position and thus correct dental occlusion was achieved. Results are immediate and the patient was happy to have his jaw bone correction done without any scars on the face. His profile also improved dramatically giving him a renewed confidence.

A 13 year old girl was brought to our hospital by her parent’s wanting to treat her alveolar cleft defect. There was a huge oronasal communication causing a depressed nose. She was born with unilateral cleft lip and palate and was operated elsewhere in her childhood.

Maxillofacial Surgeon Dr. S. M. Balaji skillfully performed the cleft alveolar correction surgery with iliac bone graft on the parent’s request. An incision was made on the iliac crest and using the “Trap door technique” cortico-cancellous bone graft was harvested. A block of medial cortex of the iliac bone was harvested. The donor site was closed in layers.

Intraorally, a gingivomucoperiosteal flap was raised to expose the alveolar cleft defect. Since there was a huge oronasal communication causing nasal depression, the bone graft was used to reconstruct the alveolar base. The graft was fixed with a titanium screw to completely close the communication and to raise the alar base. Results were immediate. The patient and her parents were very happy to have the huge cleft defect successfully treated without scarring. 

A 25 year old man reported to our hospital with the complaint of bulge in the left side of the nostrils. He was depressed due to the asymmetry of the nostrils which affects his self-confidence considerably. He was very particular to have the correction done without any scars.

Maxillofacial Surgeon Dr. S. M. Balaji diagnosed that because of the deviated anterocaudal portion of nasal septal cartilage towards left side and footplate of medial crus was also excessively curved, the nostrils were asymmetrical.      Dr. Balaji expertly planned to correct his shape of the nostrils intra nasally. Surgically the excessively curved nasal septal cartilage and foot plate of medial crus were removed. Thus surgery was done within the nose so there are no scars on the face. Results are immediate and the patient was also happy to have his nose corrected and made pristine to his face without any scars. 

An 18-year-old boy reported to our hospital seeking expert treatment of his speech defect due to cleft birth deformity. He was born with unilateral cleft lip and palate for which he was operated upon in his childhood elsewhere.

Now he complained of nasal twang in his voice. This is due to velopharyngeal muscle incompetence which causes escape of air through the nose during speech. Maxillofacial Surgeon Dr. S.M. Balaji skillfully performed the pharyngoplasty surgery rearranging the pharyngeal muscles in correct position to create a dynamic sphincter. Suction test was positive indicating successful correction of velopharyngeal incompetence.  

A 21-year-old man reported to our hospital seeking to correct his large, bulky nose which greatly affected his facial appearance. He was very much disappointed as his nose profile was disproportionately bigger due to the huge dorsal hump of his nose.

Maxillofacial Surgeon Dr. S.M. Balaji skillfully performed the reduction rhinoplasty technique. Vertically nasal septal cartilage height was trimmed and dorsal bony hump reduction was done by medial osteotomy to reduce the height of the nose. Width of the nose was also reduced by lateral osteotomy technique. Resection of cartilaginous and bony hump was done with wide chisel. Thus bulky nose and size of the framework of the nose was reduced from inside the nose to avoid any scars on the face (closed rhinoplasty technique).

A balance between the nose shape and facial profile was achieved for a more pleasing appearance. The patient was very happy to have a narrower, shapely nose that enhanced his facial profile with absolutely no scarring. 

A 25 year old man reported to our hospital with the complaints of broad and flattened nose which gave him an aged appearance. He was not happy with his nose profile.

Maxillofacial Surgeon Dr. S. M. Balaji skillfully planned to correct his nose following Augmentation Rhinoplasty technique with alar base correction. Rib cartilage graft has been harvested and shaped to correct dorsum of the nose.  Alar base was corrected by Weir excision technique. Thus surgery was done within the nose (closed rhinoplasty technique); there are no scars on the face. Results are immediate and the patient was very happy to see his enhanced appearance of his nose without any scars. This dramatically improved his profile and renewed his confidence.

A 1.5 year old boy with isolated cleft palate was brought to our hospital for the surgical closure of the gap (cleft) in the roof of the mouth (palate). The boy’s cleft palate defect was classified as Millard’s 10 and 11.

Maxillofacial Surgeon Dr. S. M. Balaji surgically corrected the cleft palate using palatal pushback technique. Incision was made in the mid- vomerine region. The palatal flap was raised on both right and left side. The Levator palatine muscle was detached from their abnormal positions and reattached to its normal position like a hammock. A two layer closure was done. The nasal floor was closed with the vomerine flap making a reverse knot. Oral layer was sutured by vertical mattress sutures. Results are immediate and the suction test was positive which ensures improved speech. 

A 25-year-old girl reported to our hospital seeking to correct her nose defect to enhance her appearance. The middle portion of her nose appeared collapsed and depressed giving the nose an unattractive, concave, “saddle-like” appearance.

Maxillofacial Surgeon Dr. S.M. Balaji skillfully performed the rhinoplasty to correct the nose defect. A costochondral graft was harvested and used to reconstruct the collapsed dorsum of the nose. An intranasal approach was used to avoid scarring on the face. Immediately after surgery, the contour of the nose improved greatly. The nose was made sharp and pristine. Facial appearance improved distinctly and the girl was very happy to have a more attractive facial profile without any scars. 

A 3-year-old girl born with bilateral cleft lip and palate reported to our hospital seeking specialized treatment for her cleft defect in the alveolar bone (teeth bearing region of upper jaw). She was previously operated for cleft lip & cleft palate.

Due to the bilateral cleft, her maxilla or upper jaw bone was in 3 parts. Maxillofacial Surgeon Dr. S.M. Balaji performed the alveolar cleft reconstruction using the miracle protein rhBMP-2. This protein stimulates the body’s own cells to rapidly form new bone at the site of placement. Following surgery, there was complete bone fill in the cleft defects thereby joining the 3 segments into a single complete maxilla.

By using this revolutionary technology, additional bone graft surgery and scarring at the graft site is avoided. Dr. Balaji has successfully used this novel protein in complete reconstruction of several facial bone defects.

A 30-year-old man reported to our hospital seeking specialized treatment to correct his cleft nose defect. He was previously operated for cleft lip and palate elsewhere in his childhood. Due to the cleft defect his nose was collapsed on the right side and it affected his facial appearance.

Maxillofacial Surgeon Dr. S.M. Balaji expertly performed the rhinoplasty or nose correction. A cosochondral graft (rib graft) was harvested and used to reconstruct the collapsed nasal framework. The surgery was approached from inside the nose so there was no scar. Immediately after surgery, the nose appeared sharp and defined giving a more pleasing appearance. The patient was very happy to have his nose defect corrected without any scars.  

A 26-year-old girl reported to our hospital seeking expert correction of her cleft nose and jaw defect to enhance her facial profile. She was operated elsewhere in her childhood for cleft lip and cleft palate. Now her nose appeared collapsed on the left side and her protruding lower jaw deflected from a pleasing profile. 

Maxillofacial Surgeon Dr. S.M. Balaji skillfully performed a combined nose & jaw correction. A costochondral graft was harvested and used to reconstruct the collapsed portion of the nose. The procedure was done from inside the nose itself so that there are no scars. Mandibular shortening was done to make the lower jaw proportionate and to improve the facial profile. Immediately following surgery, her facial profile and appearance greatly improved and she was very happy to have a more attractive appearance without any scarring on the face. 

A 27-year-old girl reported to our hospital seeking expert treatment for her flattened nose. She wanted to improve the appearance of her nose for a more attractive facial profile.

Her nose was board and flat with the middle portion of the nose appearing obscure. Maxillofacial Surgeon Dr. S.M. Balaji expertly performed the rhinoplasty surgery. A costochondral graft was harvested and used to reconstruct the dorsum of the nose. The surgery was approached from inside the nose so there was no scarring on the face. Immediately after surgery, the nose appeared sharp, pristine and overall made the face more attractive. The patient was very happy to enhance her looks without scars. 

An 18-year-old girl reported to our hospital seeking expert treatment for her nose and jaw defect. Her flattened nose and disproportionate upper & lower jaw affected her facial profile and she was very unhappy with her appearance.

After thorough radiological investigations, Maxillofacial Surgeon Dr. S.M. Balaji diagnosed the girl to have Binder’s syndrome or maxillo-nasal dysplasia in which the development of the nose and jaw is affected leading to an unusually flat, underdeveloped mid face. Dr. Balaji skillfully performed a combined jaw & nose correction surgery to correct the facial imbalance. 

A costo-chondral graft was harvested and used to reconstruct the nose through an oral vestibular approach. Corrective jaw surgery for the upper and lower jaw was done to make the jaws proportionate and into accurate alignment. Since the procedures were done from inside the mouth, there was absolutely no scarring. With this combined rhinoplasty and jaw correction, the girl’s facial appearance improved dramatically. She was very happy to have a more pleasing appearance and balanced facial features without any scarring.  

A 22 year-old-girl born with unilateral cleft lip and palate reported to our hospital seeking expert treatment for her cleft nose defect. Due to the cleft, the left side of her nose was deformed which affected her appearance and she wanted to correct her facial profile. 

Maxillofacial Surgeon Dr. S.M. Balaji skillfully performed the cleft rhinoplasty. The left ala of the nose was severely depressed. Costo-chondral cartilage was harvested and shaped to reconstruct the nasal framework. Through an intranasal approach the depressed left ala was lifted up by placing the shaped graft.  The cartilaginous strut graft was positioned between the medial crura to reconstruct the base of the nose. Immediately after the surgery the shape and appearance of the nose improved greatly. Also since the surgery was done from inside the nose, there were no scars. The girl was very happy with her improved appearance & facial profile. 

A 13 year old boy reported to our hospital with the complaints of flattened nose profile. The boy and his parents were very unhappy due to the badly flattened nose giving him an unattractive appearance. 

Maxillofacial Surgeon Dr. S. M. Balaji expertly performed the rhinoplasty surgery to correct the profile of the nose using costo chondral graft through intra oral approach. A sulcular incision was placed and through an intraoral approach, the costo chondral graft harvested from the rib was inserted into the nasal septal region and stabilized with the adjacent nasal cartilages. Thus the dorsum of the nose was enhanced with the graft. The nose defect was successfully corrected without any scars and the results were immediate. The boy and his family were very happy with the surgery outcome and the improved facial appearance.