Best Dental Clinic in Chennai : Best Dental Implant Center in India
FOLLOW US
  • HOME
  • Surgery of The week
  • Clinical Updates
  • Archives
  • Latest News
  • VIDEOS
  • CONTACT US

Augmentation rhinoplasty for flat nose 

30/5/2016

0 Comments

 
A 26-year-old girl reported to our hospital seeking to correct the appearance of her nose. Her nose was much flat and she wanted to have a sharp nose to improve her 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. 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 her appearance. 
Preoperative facial view showing broad flat depressed dorsum of the nose
Depressed dorsum of the nose giving asymmetric profile view
Costochondral rib graft obtained to reconstruct the dorsum and columella of nose
Augmented dorsum of the nose intranasally using costochondral graft giving enhanced appearance
Postoperative profile view showing augmented dorsum with defined tip and columella of nose
0 Comments

Twice failed mandibular reconstruction done elsewhere following odontogenic keratocyst resection was successfully corrected without any scars on the face 

28/5/2016

0 Comments

 
A 32 year old woman came to our hospital for expert treatment for her lower jawbone defect. She gave the history of huge odontogenic keratocyst lesion involving left mandibular angle and ramus along with the entire condylar component was removed extraorally and reconstructed using costochondral rib graft elsewhere. But the graft got infected and removed and reconstruction plate was fixed. Later plate was broken and was removed.  Her complaint was jaw deviation towards left side and facial asymmetry. Also she wants to correct her facial appearance without any scars on the face. 

Maxillofacial Surgeon Dr. S.M. Balaji performed the clinical and radiological investigations. OPG and 3D CT scan showed complete absence of left side angle and ramus of mandible with remnants of bone graft. Dr. Balaji successfully reconstructed the huge mandibular defect maintaining the contour using titanium “L” plate and costochondral rib graft and thus missing condylar component was also reconstructed, the surgical site was closed. Patient feels very happy to have entire surgery done inside the mouth and to have complete facial asymmetry correction without any scars on the face.
Preoperative facial view showing defective facial skeleton on left side with previously operated scar line in the submandibular region
Jaw deviation towards left side due to absence of bone on left side of mandible
Digital orthopantomogram showing complete absence of angle and ramus along with condyle of mandible on left side with remnants of bone graft
Preoperative 3DCT view showing absence of ramus of mandible on left side and condylar component
Preoperative 3DCT scan view showing complete absence of left side angle and ramus of the mandible with remnants of bone graft
Costochondral rib graft obtained to reconstruct the defective portion of the mandible
Maintaining the contour of the mandible the bone plate was fixed replacing the missing condylar component
To strengthen the jaw harvested costochondral rib graft fixed to the bone plate
Immediately after suturing the mucosal flap
Postoperative digital orthopantomogram showing complete reconstruction of mandible on left side using reconstruction plate and costochondral rib graft
0 Comments

Complete smile makeover following successful jaw reconstruction & dental implants for African boy

28/5/2016

0 Comments

 
​A young African boy from Nigeria suffering from Ectodermal Dysplasia was referred to our Hospital for expert care. He had multiple missing teeth & had previously undergone bone grafting elsewhere but the graft had already resorbed & failed.
Maxillofacial Surgeon and Dental Implantologist Prof. Dr. S.M. Balaji performed the complete jaw bone reconstruction using costochondral rib graft . Implants were placed to replace his missing teeth. Following osseointegration of the implants, cosmetically well blended fixed ceramic prosthesis was given enhancing the appearance.
Multiple missing teeth in a boy suffering from Ectodermal Dysplasia
Xray before surgery
Failed bone graft done elsewhere
Harvested rib graft fixed to upper jaw bone
Lower jaw bone strengthened with rib graft
X-ray taken just after jaw reconstruction & implant surgery
Following ceramic prosthesis fixation giving enhanced natural smile
0 Comments

Cleft rhinoplasty with secondary lip correction without scars

21/5/2016

0 Comments

 
​A 16 -year-old girl reported to our hospital seeking specialized treatment to correct her cleft nose defect. She was previously operated for cleft lip and palate elsewhere. Due to the cleft defect her nose was collapsed on the left side and it affected her facial appearance.
Maxillofacial Surgeon Dr. S.M. Balaji expertly performed the Corrective rhinoplasty or nose correction. A costochondral 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. Secondary lip repair was also done to correct the vermillion defect. Immediately after surgery, the nose appeared sharp and definite giving a more pleasing appearance. The patient was very happy to have her nose defect corrected without any visible surgical marks on the face. 
Defective nose due to cleft and short upper lip due to incorrect lip repair done elsewhere
Depressed columella of nose and left alar shape was defective due to incorrect primary lip repair
Costochondral rib graft obtained from right side to reconstruct the ala of the nose
Immediate postoperative view showing corrected shape of the nose giving enhanced appearance
Raised columella of nose intranasally also shape of the left ala was also corrected giving symmetrical appearance
0 Comments

GROWTH CENTER TRANSPLANTATION USING COSTOCHONDRAL RIB GRAFT FOR BILATERAL TMJ ANKYLOSIS CORRECTION

19/5/2016

0 Comments

 
A 6 year old boy was brought to our hospital with a complaint of decreased mouth opening and facial deformity. No history of trauma elicited by his parents. Extra oral examination revealed severely retruded mandible, flattened lower face and complete restriction in mouth opening.
OPG revealed obliterated right joint space elongated coronoid process, reduced ramal height and prominent antegonial notch. The case was diagnosed as true right TMJ bony ankylosis with developing secondary facial deformity.  
Maxillofacial Surgeon Dr. S. M. Balaji successfully performed gap arthroplasty using temporalis flap interpositioning. Followed by active physiotherapy, mouth opening improved dramatically. But patient failed to be on regular follow up.
After 9 years, exactly at the age of 15, patient reported with the complaint of restricted mouth opening, severe secondary facial deformity and retruded chin giving bird face appearance.
On thorough clinical and radiological examination, it was diagnosed as left TMJ ankylosis with functional right pseudo joint. Dr. S. M. Balaji performed left gap arthroplasty and bilateral condylar component reconstruction using 5th and 7th costochondral rib graft (CCG).
Postoperative mouth opening was adequate. Over 8 years follow up, bilateral CCG was favorable and lower facial projection was improved significantly with increased mouth opening.
Preoperative profile view showing retruded mandible with ill defined chin at the age of 6
Preoperative OPG showing reduced right joint space.
Intraoperative view of the ankylotic mass
Post gap arthroplasty
Preop view at the age of 15 showing severe retrognathic mandible with restricted mouth opening. Note the double chin deformity
Mouth opening with chin deviation and double chin deformity
Profile view showing retruded chin with deficient hyo-mental distance
Preoperative 3DCT view showing hypertrophic coronoid process
Preoperative 3D CT lateral view showing obliterated joint space with hypertrophic coronoid process
Harvesting of the rib graft-following a curvilinear incision layerwise dissection done exposing the right sixth rib
Harvested rib graft with the cartilage cap
Securing of the cartilagenous graft using 4-0 Prolene
Graft introduced into the surgical site for TMJ reconstruction
Securing of the graft at the mandibular posterior border using stainless steel L plates
Postoperative view at the age of 20
Postoperative mouth opening with no chin deviation
Postoperative profile view showing enhanced appearance with prominent chin and increased hyo-mental distance
Pre and postoperative profile view. Note the improvement in facial profile.
0 Comments

Facial asymmetry correction using Distraction osteogenesis

13/5/2016

0 Comments

 
Hemifacial microsomia is a condition in which there is an under-development of one side of the face resulting in facial asymmetry. The affected side of the face appears disproportionately smaller than the other. Characteristically, the lower jaw (mandible), facial soft tissues & musculature, cheek and ear on one side of the face is poorly developed. Sometimes, structural defects in the eye may also be seen. A 28-year-old boy afflicted with Hemifacial Microsomia reported to our Hospital. His lower jaw and ear was under-developed on the right side. He had a slanting bite and an obvious asymmetry of the face. A radiographic examination showed a grossly under-developed lower jaw (mandible) on the right side. There was found to be a bone deformity of about 20 mm.
The goal of the treatment is to elongate the deficient jaw bone to restore facial symmetry and correct the slanting bite (occlusion). To achieve this, an advanced and effective treatment technique is distraction osteogenesis. This is a new technique for regenerating new bone by slow, progressive stretching of the bone, without requiring a bone graft.
Eminent Craniofacial Surgeon Dr. S.M. Balaji is a pioneer in introducing this revolutionary technique and has successfully rehabilitated the maximum number of patients afflicted with facial disfigurements in the country.
In distraction osteogenesis, the jaw bone on the deficient side is cut. A sophisticated device called distractor is placed such that the two arms of the device are fixed to the two segments of jaw bone. After a few days, a screw attached to the distractor is turned gradually, ideally at a rate of 1 mm per day. When this is done, the two cut segments move apart and new bone is formed in the resultant gap. After the required length is achieved and new bone is stabilized, the distractor device is removed subsequently correcting the asymmetry of the face.
This is a powerful tissue engineering technique for generating bone for the desired volume. The overlying soft tissues that are deficient also are expanded, therefore along with the underlying bone deformity, the overlying skin and soft tissue defect is also corrected.
This is the only procedure to increase the size of the jaw bones after the cessation of actual bone growth. For this patient, Dr. Balaji adopted a stage-by-stage rehabilitation. To correct the jaw deformity, he applied the innovative simultaneous maxillary and mandibular distraction procedure wherein new bone is formed in both the upper and lower jaws simultaneously to restore facial symmetry.
Preoperative facial view showing asymmetrical face ( short face on left side)
Slanting bite (occlusal cant) due to retarded development of facial bones on left side
Preoperative 3DCT showing retarded development of maxilla and mandible on left side
After distraction showing symmetrical appearance and elongated genium highlighted in 3DCT scan image
Immediately after fixing the distractor device in position
After completion of distraction and formation of callus at the end of consolidation before distractor removal
3DCT scan showing good new bone formation
Enhanced bone formation following distraction osteogenesis
During distractor removal the genial excess was alos corrected
Excess bone was highlighted
Excess bone was removed
Excess bone removed was used to augment the symphysis on other side
Postoperative facial view showing symmetrical face without any scars on the face
Postoperative occlusal view showing corrected bite
0 Comments

Combined long lower jaw and deviated chin correction for enhanced appearance

10/5/2016

0 Comments

 
​A young man came to our hospital seeking corrective jaw surgery to enhance his appearance. His lower jaw was excessively protruding causing an incorrect teeth occlusion that caused difficulties in biting and chewing. Additionally his chin bone was deviated away from the midline giving his face an asymmetric, crooked appearance.
Maxillofacial surgeon Dr. S.M. Balaji planned to correct the jaw defect with a combined bilateral Obwegeser’s sagittal split osteotomy and genioplasty. The mandible was set back to correct the alignment and bite using bilateral Obwegeser’s sagittal split osteotomy. With genioplasty, the deviated chin bone was corrected. The procedure was done from inside the mouth so there were no scars. Immediately after this corrective jaw surgery, the man’s appearance was greatly improved and he is very happy with the enhanced aesthetics.
Preoperative profile view showing disproportionately long lower jaw
Preoperative 3DCT scan showing long lower jaw and reverse bite
Preoperative introral view showing reverse bite
Intraoperative view showing corrected lower jaw bone and bite
Postoperative profile view showing corrected lower jaw alignment without any visible scars on the face
0 Comments

Surgical correction of sunken eye due to fibrous dysplasia without much visible scars on the face

9/5/2016

0 Comments

 
This is a 26-old male who sought treatment for his left sunken eye with constant tearing from left eye. He had been diagnosed with a rare bone disease called fibrous dysplasia at the age of 12 years. In this disease, the bone is slowly replaced with fibrous tissue and the growth of the tissue assumes large proportion. For this patient, the disease was limited to only the orbital bone part. As the orbit (eye socket) bones were pressing the eye, 8 years back, a surgery was performed to relieve the pressure on the eyeball. The result of this surgery leads to improper positioning of the eyeball in the eye socket, resulting in sunken misplaced left eye. Also, as a result of the surgery, there was a constant overflow of tears from the left eye.

The current treatment plan is to correct, shape the orbit and position the eyeball correctly. All this procedure needs to be performed without affecting the vision and delicate optic nerve. 
 An upper eyelid incision was placed just below the upper eyebrow along previous scars. Through this incision and a sub-ciliary incison, the bone of the upper margin was shaped. All removed bone was carefully salvaged. Through an inferior medial canthus region, the lower eyelid region was approached. In the lower margin, preparation of the bone was done. Eye tissues were carefully dislodged at needed areas. The salvaged bones were placed and screwed. This gave a new, improved frame work for the orbit. The punctum of tear gland were identified.

 A delicate silicon tube was carefully inserted and the blocks removed. The tube was retrieved through an artificial opening in to inferior nasal meatus in the nasal cavity. By the suturing of the ductal mucosa with the nasal mucosa, the patency is ensured. By this surgery called dacryocystorhinostomy (DCR), the tears are redirected in to nasal mucosa so that there is no excess tear overflow. A modified “Y” medial canthoplexy was performed to ensure the proper positioning of the eye socket and eyeball. This was a customized technique developed at BDCH. This results in perfectly looking eye socket and eyeball. After the procedure, all movements of eye ball indicated that there had been no damage to the functioning of eye, indicating the complete success of the surgery.
.Preoperative frontal view showing asymmetric interpupillary distance
Preoperative worm's eye view
Slicing of excess supra orbital bone
Using surgical saw the excess bone sliced from supraorbital region
.Refixation of bone in suitable position in supraorbital region using titanium plates & screws
Y shaped plate fixation done to hold the medial canthal in postion
Infraorbital wall elevation using harvested excess grafts
Postoperative view symmetric interpupillary distance front image-compare
0 Comments

Corrective jaw surgery and augmentation genioplasty to enhance facial appearance

7/5/2016

0 Comments

 
A 26 year old boy visited our hospital seeking for correction of his facial profile to enhance the appearance. He was under orthodontic treatment for past 2 years elsewhere. But he was not satisfied with the results and thus he wants to have surgical correction of his jaw without any scars on the face.
​
After thorough clinical and radiological examination, Maxillofacial Surgeon Dr. S.M.Balaji planned to correct his face by following corrective jaw surgery. He has short upper lip due to vertical maxillary excess which was corrected by Lefort I osteotomy. His profile shows short chin giving round face appearance. This was corrected by augmenting the genium using costochondral rib graft. Thus entire surgery was done inside the mouth and his facial appearance improved dramatically. Patient feels very happy to have the entire facial correction in a single surgery and without any visible surgical marks on the face.
Preoperative facial view showing short lip and retruded chin
Preoperative profile view showing short chin and prominent maxilla
Preoperative digital lateral cephalogram showing protruding maxilla and retruded chin
Costochondral rib graft harvested to augment the genium of mandible
Harvested rib graft used to augment the chin
Lefort I osteotomy done for upper jaw
Symphyseal region prepared to receive costochondral graft
Rib graft prepared to augment the chin
Rib graft prepared
Harvested costochondral graft used to augment the symphyseal region of mandible
Postoperative view showing enhanced appearance without any scars on the face
Postoperative profile view showing augmented chin and corrected profile
Postoperative digital lateral cephalogram showing augmented genium and corrected maxilla
0 Comments

Bilateral Cleft Lip- Successful Primary Correction

4/5/2016

0 Comments

 
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.
Maxillofacial Surgeon Dr. S.M. Balaji performed the primary cleft lip correction surgery 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. 
Bilateral cleft lip and palate defect in 3 months old baby boy
Immediately after suturing using Paul Black's technique
Immediately after suture removal following seven days after surgery
0 Comments

    Categories

    All
    Abbe Flap Technique
    Advanced Transport Distraction Osteogenesis
    Advancement Genioplasty
    Alveolar Cleft Repair
    Alveolar Distraction
    Ameloblastoma
    Augmentation Genioplasty
    Augmentation Rhinoplasty
    Bat Ear Correction
    Bilateral Cleft Lip Palate
    Blepharoplasty
    Bone Defect Reconstruction
    Bone Grafting
    Bone Morphogenetic Protein(BMP)
    Broad Flattened Nose Correction
    Bulky Nose Correction
    Chin Correction
    Chin Correction Surgery
    Cleft Lip & Palate Surgery
    Cleft Nose
    Cleft Palate Repair
    Cleft Rhinoplasty
    Complete Facial Rehabilitation
    Complex Facial Fractures
    Condylar Fracture Surgery
    Correction Of Hypoplastic Ramus
    Corrective Jaw Surgery
    Cosmetic Cleft Nose Correction
    Cosmetic Nose Correction
    Cosmetic Rhinoplasty
    Cosmetic Surgery
    Craniofacial Deformities
    Craniofacial Reconstruction
    Craniofacial Surgery
    Cyst Removal
    Dental Implant
    Dentigerous Cyst
    Deviated Nose Correction
    Diplopia
    Distraction Osteogenesis
    Ear Correction
    Ear Defect
    Ear Reconstructive Surgery
    Epiphora
    Extruding Infected MEDPOR
    Eyebrow Correction
    Face Enhancement
    Face Reconstruction
    Facial Asymmetry Correction
    Facial Bone Fracture
    Facial Burn Injury
    Facial Palsy Surgery
    Fibrous Dysplasia
    Flat Nose Correction
    Forehead Bone Fracture
    Forehead Deformity
    Forehead Flap
    Frontal Bossing Correction
    Gummy Smile
    Hemifacial Microsomia
    Hypertelorism Surgery
    Implant
    Incomplete Cleft Lip
    Isolated Cleft Palate Repair
    Jaw Correction Surgery
    Jaw Cyst
    Jaw Deformity
    Jaw Fracture Surgery
    Jaw Joint Ankylosis
    Jaw Reconstructive Surgery
    Jaw Surgery
    Lip Correction
    Lip Defect Correction
    Lip Revision
    Locked Jaw
    Lower Jaw Fracture
    Low Lying Upper Eyelid Correction
    Macrostomia Correction
    Mandible Correction
    Mandible Reconstruction
    Maxillofacial Surgery India
    Maxillomandibular Distraction
    Maxilofacial Surgery
    Micrognathic Mandible Correction
    Microtia
    Nasal Glial Heterotopia
    Naso-orbito-ethmoidal Fracture
    Nose And Lip Correction
    Nose Asymmetry Correction
    Nose Correction
    Nose Job
    Nose Reconstructive Surgery
    Oral Submucous Fibrosis
    Oral Tumor Removal
    Orbital Correction
    Orehead Defect
    Orthognathic Surgery
    Parrot-beak Nose
    Parry Romberg Syndrome
    Pharyngoplasty
    Plastic Surgery
    Primary Cleft Lip Repair
    Profile EnhancemeP
    Reduction Glossectomy
    Reduction Rhinoplasty
    Removal Of Capillary Hemangioma
    RhBMP 2
    RhBMP-2
    Rhinoplasty
    Road Accident Trauma
    Road Accident - Trauma
    Scar Revision
    Secondary Cleft Palate
    Sinus Lift
    Smile Makeover
    Speech Correction
    Square-face Correction
    Surgery Without Scar
    Tessier Nose Defect
    Tissue Expansion
    TMJ Ankylosis
    Tongue Correction
    Tongue Surgery
    Trauma
    Trauma Treatment
    Triangular Shaped Forehead
    Tumor Resection
    Unilateral Cleft Lip
    Unilateral Cleft Lip And Palate
    Unilateral Cleft Lip Repair
    Velopharyngeal Incompetence

    Archives

    April 2021
    March 2021
    January 2021
    December 2020
    April 2020
    March 2019
    February 2019
    January 2018
    November 2017
    October 2017
    September 2017
    June 2017
    May 2017
    April 2017
    March 2017
    January 2017
    December 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016
    February 2016
    January 2016
    December 2015
    October 2015
    September 2015
    August 2015
    July 2015
    June 2015
    May 2015
    April 2015
    March 2015
    February 2015
    January 2015
    December 2014
    November 2014
    October 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    December 2013
    November 2013

    RSS Feed

Copyright © 2020 Balaji Dental & Craniofacial Hospital | All rights reserved | Powered by BALAJI DENTAL HOSPITAL