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Reduction rhinoplasty for improved facial appearance

28/8/2016

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​A young man came to our hospital wanting to correct the shape of his broad, bulky nose that gave his face an unattractive appearance.
Maxillofacial Surgeon Dr. S.M. Balaji performed a reduction rhinoplasty. The large bulky nose was reduced by removing excessively curved lower lateral nasal septal cartilages bilaterally and medial osteotomy done to reduce the height of the nose. Thus nose was made more proportionate and sharp with reduction rhinoplasty. Entire surgery was approached through the nose avoiding scar formation.  The man was very happy that his appearance improved greatly and his nose defect was corrected without any visible surgical marks on the face.
Preoperative view showing broad nose with bulky tip and ill defined nasal bridge
Columellar view showing bulky dorsum of nose
Intraoperative view showing removal of excessively curved lower lateral nasal septal cartilage
Medial septal cartilage was reduced intransally
Excessive nasal septal and lateral nasal cartilage was removed
Immediate postoperative view showing pristine nose without any visible surgical marks
Columellar view showing corrected dorsum of nose with narrow tip
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Cleft rhinoplasty without scars

26/8/2016

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​25-year-old men reported to our hospital seeking specialized treatment to correct his cleft nose defect. He was previously operated for cleft lip and palate elsewhere. Due to the cleft defect his nose was collapsed on the left side and it affected his facial appearance.
Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the 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 his nose defect corrected without any visible surgical marks on the face. 
Preoperative facial view showing broad nose with deviated nose tip towards right side due to cleft defect
Columellar view showing depressed nasal tip with ill defined columella and asymmetric nostrils
Costochondral rib graft harvested to reconstruct the shape of the nose
Immediately after suturing showing corrected dorsum of the nose with cleft lip revision
Columellar view showing corrected shape of the nostrils using rib graft intranasally without any visible surgical marks on the face
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Successful removal and reconstruction of cystic lesion in lower jaw 

20/8/2016

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​A 28 year-old man came to our hospital with a complaint of pain in his lower jaw. A digital X-ray and 3DCT scan was taken revealed a large cystic lesion extending from canine to canine of the mandible with complete erosion of the labial plate.
 Maxillofacial surgeon Dr. S.M. Balaji expertly removed the entire cystic lesion along with the lining with affected teeth in toto. Reconstruction of the bone defect was done using bone graft obtained from the retromolar region.  Following surgery the wound healed well and the patient was happy to be cured of his ailment.
Preoperative digital orthopantomogram showing osteolytic cystic lesion involving lower anterior region of mandible
3DCT view showing buccal cortex erosion in lower anterior region of mandible
Intraoperative view showing surgical exposure of cystic lesion
Cystic lesion removed along with the lining and prepared for HPE
Bone defect after removal of the cystic lesion
Bone graft obtained from the impacted teeth region
Removed of affected mandibular anterior teeth and impacted third molars
Bone graft fixed into the defective region of mandible
Immediately after suturing
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Resection of huge mandibular tumor and reconstruction using univector intraoral mandibular distraction technique

16/8/2016

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This is a case of ameloblastoma involving right side of mandible. Resection and reconstruction of the huge mandibular defect was done without any bone grafting using distraction osteogenesis. Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected using univector intraoral mandibular distraction technique. Simultaneous resection of huge tumor and reconstruction using native bone was done using distraction osteogenesis. By sequential activation of the distractor device, the native bone was made to grow and fill the entire bone defect. Patient feels happy to have both removal and reconstruction of the entire jaw bone defect without any bone graft. 
Preoperative view showing weel defined swelling in the lower border of mandible and note the skin over the swelling is inflammed
Intraoperative view showing exposure of the lesion through submandibular approach followed by resection
Resected specimen
Adaptation and fixation of the plate guided univector unidirectional straight mandibular distractor
Fixation of the mesh foot plates and completion of planned osteotomy
Primary closure of the surgical wound.
Sequential OPG showing the movement of the transport disc with daily activation
Postoperative OPG showing bone formation following distraction osteogenesis
Postoperative view showing maintained contour of the lower jaw without any visible scars on the face
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