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Successful correction of incomplete cleft lip

30/7/2014

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A 3-month-old baby girl with incomplete cleft lip was brought to our hospital by her parents for surgical treatment. Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the primary cleft lip repair using Modified Millard’s technique. On the 7th postoperative day following surgery the sutures were removed & there was hardly any scar. The parents were very happy to see their baby’s improved appearance. 
Preoperative view showing incomplete cleft lip defect in 3 months old baby
During procedure - primary cleft lip repair
Primary cleft lip closure
Immediate postoperative view following suture removal after seven days of surgery
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Cosmetic Rhinoplasty for flattened-nose correction

28/7/2014

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Preoperative view showing broad flattened nose with illdefined nasal bridge
Harvested costochondral cartilage used to augment the dorsum of the nose
Immediate postoperative view showing augmented dorsum of the nose without any surgical marks
A 26-year-old man came to our hospital seeking to enhance his appearance by correcting the shape of his nose. His nose was flattened & broad that affected his facial profile.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the augmentation rhinoplasty procedure. A costochondral rib graft was harvested. The dorsum of the nose was augmented using the harvested graft. Immediately after surgery the nose appeared sharp & defined which greatly enhanced his looks. The patient was happy with the enhanced cosmetic results achieved without any scars since the surgery was done from within the nose. 
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Corrective jaw surgery (orthognathic surgery) for gummy smile

25/7/2014

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An 18-year-old girl from Bangalore was brought to our hospital by her parents for expert correction of her protruding upper jaw that caused an unattractive “gummy smile”. The girl was about to begin her college education and she was very self-conscious about her appearance.

Her facial bones were analyzed using digital x-rays. Her upper jaw or Maxilla was disproportionately larger as compared to the lower jaw and her upper lip was short causing too much of the gums to be visible while smiling. Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the corrective jaw surgery or orthognathic surgery with Le Fort I osteotomy. The upper jaw was set back, reshaped & realigned in perfect facial harmony. The entire procedure was done from inside the mouth so there were no scars. Immediately following surgery the girl’s appearance was greatly enhanced and her more attractive, pleasing smile boosted her confidence.
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Cleft palate repair for a baby with unilateral cleft lip palate

24/7/2014

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A 11-month old baby girl was brought to our hospital by her parents for cleft palate repair. She was born with unilateral cleft lip & palate. She was operated for primary cleft lip repair when she was 3 months old.

Maxillofacial Surgeon Prof. S.M. Balaji successfully performed the cleft palate repair. In the palatal pushback technique, a palatal flap was raised. The abnormally attached palate muscles were detached & reattached like a hammock in a correct position. A 2–layered closure – of the nasal and oral floor was done. Further cleft management will be done subsequently. 
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Surgical correction of Enlarged tongue (Reduction glossectomy)

22/7/2014

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A 14 year old girl was brought to our hospital by her parents with the complains of inability to close the mouth due to large tongue. She was not able to consume food and it also made her embarrassing for any kind of social interaction. Her parents were very particular to have the surgical correction to be done without any scars on her face.

Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected her jaw as well as the enlarged tongue in a single surgery. Following reduction glossectomy and mandibular  subapical osteotomy procedure, she was able to close her mouth and take her food without any problem. Her parents were also very happy to have her entire jaw as well as tongue correction done without any scars on her face.  Results are immediate and this enhanced her appearance which boosted her confidence level. 
Preoperative view showing large & lengthy tongue with inability to close the mouth
During glossectomy procedure the length as well as the width of the tongue was reduced
Immediate postoperative view showing complete reduction of the volume of the tongue
Postoperative view showing reduced bulk of the tongue without any surgical marks and enhanced appearance
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Augmentation rhinoplasty for cleft nose correction

21/7/2014

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A 16-year-old girl from Chennai was brought to our hospital by 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.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the cleft rhinoplasty & cleft lip revision. A costochondral rib graft was harvested and used to augment the dorsum of the nose. The collapsed left nostril was reconstructed with a strut graft. The surgery was done from inside the nose so there were no scars. Lip revision was also done simultaneously. Immediately following surgery, the girl’s appearance improved greatly and she was very happy with the surgery outcome.
Preoperative view showing defective cleft nose on the left side with unsightly scar on the lip due to previous surgery
Preoperative view showing depressed left side nostril with illdefined ala of the nose on the left side due to cleft defect
Harvested costochondral graft to augment the dorsum of the nose and shape of the nostrils
Immediate postoperative view showing enhanced dorsum of the nose with symmetrical appearance without any scars
Postoperative view showing reconstructed shape of the nostrils along with lip revision giving prisitne appearance
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Extremely thin jaw bones reconstructed and rehabilitated with implants & prosthesis

14/7/2014

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A 25-year-old man from Seychelles 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 in a dental clinic in his hometown. 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. Rib graft was harvested & used to reconstruct the thin upper & lower jaw bone. rhBMP-2 was placed to stimulate new bone formation & dental implants were fixed in the missing teeth regions in the maxilla & mandible. Following complete osseointegration of the implants with the surrounding bone, teeth prosthesis were fixed. The man was very happy to have fixed replacement of his missing teeth and to get back his confident, pleasing smile that remarkably improved his appearance. 
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Successful square-face correction without scars

12/7/2014

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A 19-year-old girl from Shillong was brought to our hospital by her parents seeking to correct her square-shaped face that gave her a masculine appearance. The girl was very anxious & wanted a cosmetic correction to enhance her appearance without any scars.

Maxillofacial Surgeon Dr. S.M. Balaji diagnosed that the square-shaped face was due to masseter hypertrophy. Masseter muscle is mainly responsible for the movements of the lower jaw & plays an important role in facial aesthetics. When the muscle on both right & left side becomes enlarged or thickened, it gives the lower third of the face a wide, square-shaped appearance.

Dr. Balaji surgically reduced the bulk of the enlarged Masseter muscle from within the mouth itself so there were no scars. Along with the muscle reduction, the excess part of the gonial angle of the mandible was also trimmed. Immediately after surgery the lower jaw appeared more proportionate and her appearance greatly improved. The girl & her family were very happy to have a more attractive, natural look. 
Preoperative view showing square face appearance due to broad lower half of the face
During procedure - intraorally hypertrophic tissue of masseter muscle was removed from right side
During procedure - intraorally hypertrophic tissue of masseter muscle was removed from left side
Immediate postoperative view showing enhanced appearance of the face with square face defect corrected without any scars
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Reduction rhinoplasty for parrot-beak nose

11/7/2014

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A 26-year-old girl came to our hospital seeking to correct the shape of her nose. Her nose was parrot-beaked shaped which deflected from an attractive appearance. She was to get married in a few months and wanted to cosmetically correct the shape of her nose without any scars.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the reduction rhinoplasty. A medial & lateral osteotomy was performed and the nasal septal cartilage was reduced correcting the nasal framework. The procedure was done from inside the nose so there was no scarring. Immediately following surgery the shape of the nose was enhanced greatly improving her appearance. She was very happy to have her nose restructured without any scars. 
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Forehead defect successfully treated along with eyebrow correction (Blepharoplasty)

10/7/2014

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A 23-year-old man reported to our hospital seeking to correct his drooping left eyebrow. He gave a history of having met with a vehicular accident several months ago following which he noticed a depression in his forehead causing his left eyebrow to be at a lower level than the right, affecting his appearance.

A 3D CT scan revealed a fracture of the frontal bone on the left side. Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the forehead defect reconstruction. Lid crease incision was placed over the left eye to avoid scar. Skin, subcutaneous tissue was tunneled through to reach the forehead defect. The forehead bone was drilled above the left eye & a bioresorbable endotine spike implant fixed to elevate the bone depression & raise the eyebrow to about 10 mm from the orbital rim. The pericranium was raised and the bone depression above the left eye towards midline was reconstructed with a rib graft. 

Immediately after surgery, the man’s appearance improved greatly. The reconstructed defect & normally-positioned left eyebrow restored the facial symmetry and the man was very happy with the scarless correction. 
Preoperative view showing asymmetrical eyebrow level with excessive bulkiness in left eyelid
Lid crease incision made to avoid scarring postoperatively
Through tunneling the forehead defect was exposed after raising the pericranium
Distal aspect of the supraorbital rim was prepared to receive endotine spike implant
Endotine implant fixed successfully in the prepared region to raise the eyebrow equivalent to opposite side
Harvested costochondral graft fixed in the mesial aspect of supraorbital rim to correct the forehead defect
Immediate postoperative view showing corrected eyebrow level and lid crease incision was completely closed which gives scarless results
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Successful cleft palate repair surgery

9/7/2014

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A 10-month old baby girl born with unilateral cleft lip and palate was brought to our hospital by her parents for cleft palate repair. She was previously operated for primary cleft lip repair few months ago.

Maxillofacial Surgeon Prof. S.M. Balaji successfully performed the cleft palate repair using palatal pushback technique. A palatal flap was raised on right & left side and abnormally attached palate muscles were detached & reattached in a normal position like a hammock. The nasal floor & oral floor were closed in two layers. Following surgery, positive suction test was seen indicating successful palate repair surgery.
Baby girl with unilateral cleft lip palate at 3 months of age
Few weeks after primary cleft lip repair
Cleft palate defect before surgery
Immediately after surgery- successful closure of cleft palate defect
Picture
Dr S.M. Balaji with the baby after successful surgery
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Primary lip repair for baby with unilateral cleft lip and palate

7/7/2014

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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.

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 remarkable 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.
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Successful reduction rhinoplasty for enhanced appearance

5/7/2014

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A 25-year-old man reported to our hospital seeking to correct the shape of his nose. His nose was disproportionately large and bulky that affected his appearance. He sought to enhance the appearance of his nose for a more pleasing look.

Maxillofacial surgeon Dr. S.M. Balaji successfully performed the reduction rhinoplasty to reduce the size of the nasal framework. A horizontal, medial & lateral osteotomy was performed to reduce the nose height along with weir excision for narrowing the alar base. The surgery was done from inside the nose to avoid scarring. Immediately following surgery the nose appeared sharp & proportionate greatly enhancing the facial appearance.
Preoperative view showing broad nasal bridge with alar base of the nose
Preoperative view showing increased height of the nose with raised nostril space
During procedure lower lateral nasal cartilage was removed to reduce the bulkiness of the tip of the nose
Immediate postoperative view showing pristine nose without any scars
Postoperative view showing corrected shape of the alar base by Weir excision
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Successful rhinoplasty for shortening elongated nose

5/7/2014

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A 20-year old man reported to our hospital seeking to correct the shape of his nose. His nose was very elongated that gave the face an unattractive appearance.

Maxillofacial surgeon Dr. S.M. Balaji successfully performed the rhinoplasty to enhance the appearance of the nose. The caudal end of the alar cartilage was reduced. Also the length of the septum and vestibular mucosa were reduced and the nose was shortened. The procedure was done from inside the nose to avoid scars. Immediately following rhinoplasty, the nose now made proportionate & sharp greatly enhanced the facial appearance & the patient was very happy to have a more attractive, scarless look.
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Augmentation rhinoplasty & bulky nose-tip reduction

2/7/2014

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A 35-year-old woman reported to our hospital seeking to improve the structure of her nose to improve her facial appearance. The bridge of the nose was depressed and appeared excessively concave in the profile view. Also the tip of her nose was very stout & bulky. 

Maxillofacial surgeon Dr. S.M. Balaji successfully performed the augmentation rhinoplasty. A costochondral cartilage graft was harvested from the rib and used to reconstruct the depressed dorsum of the nose. Excessive fat was removed from the nose tip to make it proportionate & pristine. The procedure was done inside the nose so there was no scar. Following rhinoplasty, the patient was very happy to have a sharp, defined nose making her face more attractive. 
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Successful unilateral cleft lip repair

1/7/2014

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A 3 months baby girl born with unilateral cleft lip and palate was brought to our hospital by her parents for surgical correction of cleft lip defect.

 Maxillofacial Surgeon Dr. S. M. Balaji skillfully corrected the unilateral cleft lip defect by following Modified Millard’s technique. Results are immediate and the baby’s parents were happy to see the surgical correction done without much scars. Enhanced post operative view immediately after suture removal following seven days of surgery was seen.
Preoperative view showing unilateral cleft lip and palate in a 3 months baby girl
During procedure - primary lip repair
Immediate postoperative view showing primary cleft lip repair
Postopertaive view following suture removal after seven days of surgery
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Successful removal of capillary hemangioma of the palate

30/6/2014

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35 year old women reported to our hospital with the complaints of huge swelling in the palatal region which was firm and rubbery without any surface ulceration for past 2 months. She continued that the swelling was painful with occasional bleeding noticed.

Maxillofacial surgeon Dr. S. M. Balaji skillfully diagnosed after thorough clinical examination as capillary hemangioma of palatal mucosa. Surgically the entire hemangiomatous lesion in the palate was excised and the vascular source was ligated completely. Patient was happy to have complete removal of the swelling. Postoperative view after 3 weeks showing good healing.  
Preoperative intraoral view showing huge hemangioma lesion in the left side of the palate
Complete excision of the hemangioma tissue from the palatal region
Postoperative view after 3 weeks showing enhanced healing without any remenents
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