Balaji Dental and Craniofacial Hospital - Dr. S.M Balaji, Maxillofacial Surgeron, India - Best Dental Clinic in Chennai : Best Dental Implant Center in India

Combined jaw and nose correction for improved appearance

27/8/2014

A 30-year-old man reported to our hospital seeking to correct the shape of his nose and jaw in order to improve his appearance. His nose was too broad and his upper and lower jaw was very protruding which made his facial profile unattractive.

Maxillofacial Surgeon Dr. S.M. Balaji performed a combined nose and jaw correction. A reduction rhinoplasty was done to reduce the bulky nose and make it slender & sharp. Corrective jaw surgery or orthognathic surgery was done in the same procedure. Excess bone from the upper and lower jaw was removed contouring the jaws and aligning it in more perfect balance with the facial features. Rhinoplasty and orthognathic surgery was done from inside the nose and mouth respectively therefore there was no scarring. Immediately following surgery, the man’s facial profile was enhanced and he was very happy with his improved looks.

Preoperative view showing bulky nose

Profile view showing protruding upper and lower jaw

During procedure upper jaw excess removed with bulky tip of the nose reduced

Postoperative view showing pristine nose without any surgical marks

Postoperative profile view showing enhanced appearance of the face without any scars

Combined rhinoplasty and lip scar revision to enhance appearance for cleft patient

21/8/2014

A 25-year-old girl came to our hospital seeking to correct the defects in her nose and upper lip to enhance her appearance. She was born with unilateral cleft lip and palate for which she was operated in her childhood. Now her nose appeared collapsed & flattened and there was an irregular scar on her upper lip.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed a combined augmentation rhinoplasty and lip revision to correct the defects and improve her appearance. A costochondral rib graft was harvested and used to reconstruct the nasal framework. Dorsum of nose was augmented and alar base reconstruction was done through weir incisions. With this the nose was reshaped to a sharper, pristine form. Upper lip scar revision was also done in the same surgery. Immediately following correction of the nose & lip defect, her appearance improved greatly and she was very pleased with the surgery outcome.

Preoperative view showing broad nose with unsightly scar on the upper lip due to cleft defect

Costochondral graft harvested to reconstruct the nasal framework

Harvested graft used to augment the dorsum of the nose

Immediate postoperative view showing reduced size of the nose with corrected alar base and secondary lip revision done with minimal surgical marks

Corrective surgery for protruding upper jaw

19/8/2014

A 32-year-old man reported to our hospital seeking to correct his protruding upper jaw to enhance his appearance. His forwardly placed upper jaw and upper teeth made it difficult to close the mouth normally and he was very self-conscious of his looks.

Radiographic analysis of the facial bones showed that his maxilla (upper jaw) was disproportionately large compared to the lower jaw which caused the upper jaw and teeth to be very protruding. Maxillofacial surgeon Dr. S.M. Balaji performed the corrective jaw surgery or orthognathic surgery. The excess bone from the upper jaw was removed & the jaw was set back in proper alignment with the lower jaw. Immediately following surgery his appearance improved with the more balanced features. The procedure was done from within the mouth so there were no scars. The man was very happy with his new, improved look.

Severely protruding upper jaw causing inability to close the mouth normally and unpleasant appearance

Very forwardly placed upper teeth due to large upper jaw

Upper jaw sculpted and set back improving appearance without any scars

More balanced alignment of upper with lower teeth following orthognathic surgery

Combined corrective jaw surgery & sinus-lift with implant placement

16/8/2014

A 30 year old lady from Saudi Arabia reported to our hospital with the complaints of missing teeth and more forwardly placed upper front teeth. She wanted to correct both the proclination and to replace the missing teeth with the dental implants in the same visit. She consulted various dental implantologists regarding her missing teeth replacement where they refused fixed replacements due to lack of bone support.

Maxillofacial Surgeon and Implantologist Dr. S. M. Balaji successfully corrected both the proclination and replacement of her missing teeth in the same surgery. By following Le Fort I osteotomy the severely protruding upper jaw was set back to a more balanced occlusion. A sinus-lift procedure was done to enable implant placement in the decreased height region of the upper jaw. A “window” was cut & the lining of the maxillary sinus was lifted. The excess bone from the jaw correction was ingeniously packed in the space below the sinus membrane thereby increasing the width of jaw bone & implant was successfully placed. Later ceramic crowns will be fixed for complete dental rehabilitation.

Successful cleft palate repair surgery

14/8/2014

A one-and-half year old baby boy with unilateral cleft lip and palate was brought to our hospital by his parents for surgical correction of the cleft palate defect. The surgical correction of the cleft lip was done previously.

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. Over the following months further cleft management will be done.

Cleft palate defect in a baby boy

Successful cleft palate repair immediate view after surgery

Combined correction of lip & nose defect for patient with bilateral cleft lip palate

13/8/2014

A 17-year-old girl from Bangladesh reported to our hospital seeking to correct her lip and nose defect to enhance her appearance. Previously she was operated elsewhere for bilateral cleft lip & palate. Also the Abbe flap treatment done elsewhere had failed. As a result she had a very thin upper lip and her nose was broad & flattened giving her an unpleasant appearance.

Maxillofacial Surgeon Dr. S.M. Balaji performed a combined correction of the lip and nose defect. A costochondral rib graft was harvested and used to reconstruct the dorsum. A columellar strut graft was used to elevate the nose tip & reshape the nose. Immediately after surgery the nose appeared more sharp and defined.

In the specialized abbe-flap technique, a flap of tissue was taken from the lower lip, rotated across the mouth and sutured to the central, thin portion of the upper lip with the base of the flap still attached to the lower lip. Once blood supply is established, after about 3 weeks the flap will be divided making the upper lip more proportionate enhancing the appearance.

Nose and lip defect in cleft individual previously operated elsewhere

Flattened, collapsed nose defect giving an unpleasant appearance

Profile view showing nose and lip defect

Costochondral rib graft harvested

Graft used to reconstruct dorsum of the nose and columellar strut graft placed

Structure of the nose reshaped and raised immediately

Abbe flap technique- flap of tissue taken from lower lip and used to reconstruct the upper lip

Improved appearance immediately after combined lip and nose defect correction

Enhanced profile view after lip and nose reconstruction

Reduction rhinoplasty for enhanced appearance

12/8/2014

A 33-year-old man reported to our hospital seeking expert correction of his nose defect. His nose was elongated & had a sagging appearance and the tip of the nose was turned downwards. He was unhappy with his looks.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the reduction rhinoplasty to reshape the nose. The lower lateral nasal cartilage was removed from both sides and the dorsum was given a sharp, proportionate form while raising the tip of the nose. The procedure was approached from inside the nose to avoid scarring. Following surgery, the corrected nose shape improved the appearance and the man was delighted with the surgery outcome.

Preoperative view showing broad, flat nose giving asymmetrical appearance

Preoperative profile view showing elongated nose with depressed tip of the nose

During procedure - lower lateral nasal septal cartilage were removed on both the sides

Immediate postoperative view showing enhanced dorsum of the nose giving symmetrical appearance

Postoperative profile view showing corrected length and raised tip of the nose without any surgical marks

Odontome removal and complete rehabilitation with bone graft & implant

11/8/2014

A 20-year-old man reported to our clinic with a complaint of missing upper left front tooth. It appeared the tooth was buried in the gums and did not erupt completely causing an unsightly gap in the upper front teeth.

A digital X-ray revealed multiple miniature tooth-like structures in the upper left central incisor region. These are called compound odontomas. These structures obstructed the complete formation and eruption of the permanent central incisor tooth causing it to remain deeply embedded (impacted) in the upper anterior jaw bone.

Maxillofacial Surgeon & Implantologist Dr. S.M. Balaji completely removed the odontomas and impacted central incisor tooth. A bone graft was taken from the oblique ridge of the left lower jaw & fixed to the upper central incisor region. Following successful augmentation of the upper front jaw, an implant was placed & ceramic crown of exact color match was fixed. The man was very happy to have a pleasing smile with superior aesthetics.

Multiple teeth like structures (odontomes) in the front upper jaw

Digital radiograph showing odontomes obstructing the formation and eruption of central incior

Multiple teeth like structures (odontomes) surgically removed along with impacted, incompletely formed incisor

Insufficient residual bone following removal of extensive defect

Bone graft taken from oblique ridge of left lower jaw

Harvested graft fixed to the upper left central incisor region

Following good healing bone screw is removed

Implant placed in the jaw bone

Digital radiograph showing implant fixed with good stability and retention

Enhanced aesthetics after complete rehabilitation with ceramic crown

Infected bone plates of face fracture treatment done elsewhere removed successfully

9/8/2014

A 34-year-old man reported to our hospital with a complaint of severe pain in his mid forehead and upper nose region of the face. He gave a history of having met with a road traffic accident several months back in which he sustained fractures of his mid-forehead & nasal bones. He underwent fracture treatment elsewhere. Now he complained of severe pain in the treated region.

A 3D CT scan revealed infected bone plates in the fronto-nasal bones. Maxillofacial Surgeon Dr. S.M. Balaji successfully removed the infected bone screws & bone plates through small DCR incisions. Also a silastic implant that was placed elsewhere in the nose was removed through the same incision. Following surgery the patient was relieved of the pain & was happy that the procedure was done with minimal marks.

Successful correction of unilateral cleft lip defect

8/8/2014

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

Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected the unilateral cleft lip defect by following Modified Millard’s technique. Results are immediate with very minimal scar line following suture removal after seven days of surgery. Her parents were asked to bring the child after 6 months for further cleft management.

Preoperative view showing unilateral cleft lip and palate defect in 3 months old baby girl

Unilateral cleft lip defect corrected with Modified Millard's technique

Immediate postoperative view after suture removal following seven days after surgery

Simultaneous correction of lip defect with Abbe-flap technique & nose defect

4/8/2014

A 19-year-old boy from New Delhi, with unilateral cleft lip & palate was brought to our hospital by his parents for expert correction of his nose & lip defect. His cleft lip and cleft palate correction was done elsewhere in his childhood. Now his nose was disproportionately large & upper lip was too thin. He wanted to correct the shape & form of his nose & lips to improve his appearance.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed a combined correction of the nose & lip defect. A medial & lateral osteotomy of the nose was done to reduce the large nose. With this the nose was reshaped & given a more proportionate, balanced form. The lip defect was corrected with Abbe-flap technique. A flap of tissue was taken from the lower lip, rotated across the mouth & sutured to the upper lip with the base of the flap still attached to the lower lip to maintain blood supply. The flap was taken with hair follicles to ensure moustache growth. After 3 weeks once blood supply is established, the flap will be divided, giving the lips an enhanced form, function & appearance.

Preoperative frontal view showing broad, flattened nose with defective upper lip due to cleft defect

Preoperative profile view showing bulky nose with thinning of upper lip due to defective primary cleft lip repair

Reduction rhinoplasty done to reduce the bulkiness of the nose

Immediate postoperative view showing corrected upper lip defect with Abbe flap

Immediate postoperative profile view showing enhanced appearance of the face without much surgical marks

Bulky nose-tip successfully corrected with rhinoplasty

4/8/2014

A 24-year-old female reported to our hospital seeking to correct the shape of her nose to enhance her appearance. The tip of her nose was very bulky & stout that gave an unattractive look.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the nose correction. The lower lateral nasal cartilage was removed from both sides to reshape the bulky nose-tip. Immediately following surgery, the structure of the nose appeared sharp & pristine. Since the surgery was done from inside the nose there were no scars. The patient was very happy that the surgery gave her the desired results & made her face look very attractive & pleasing.

Preoperative view showing distinctive bulkiness in the tip of the nose

During procedure lower lateral nasal cartilage was removed from both the sides

Immediate postoperative view showing corrected tip of the nose with pristine appearance

Alveolar cleft repair using rhBMP-2 avoiding bone grafting

4/8/2014

A 14-year-old boy from Sri Lanka, with unilateral cleft lip and palate, was brought to our hospital by his parents for surgical correction of alveolar cleft (cleft in the teeth-bearing bone of upper jaw). Previously he was operated for cleft lip & cleft palate elsewhere.

Maxillofacial Surgeon Dr. S.M. Balaji performed the surgical correction of the alveolar cleft using the advanced rhBMP-2 (recombinant human Bone Morphogenetic Protein). This miracle protein stimulates the body’s own stem cells to form new bone at the site where it’s placed ultimately healing the bone defect. Following this, normal teeth eruption and teeth alignment can be achieved. The wonder of using this advanced technique is that additional surgery of bone grafting from the rib or hip is avoided and there is no scarring.

Preoperative view showing cleft alveolus in the unilateral cleft defect in left side

During procedure cleft alveolus was surgically exposed

Miracle protein rhBMP-2 placed in the cleft alveolus defect for the cleft closure