A Gynecologist in her late fifties, consulted at our hospital seeking fixed replacement of her mobile front teeth and missing back teeth. Previously, many other centers had hesitated to advise her dental implants citing her advanced age and severe deficiency of bone in her upper jaw. Instead, they advised her to go in for removable dentures which she refused because dentures are bulky, uncomfortable and slip out often. Also she found it very time consuming to clean and maintain her dentures in her busy schedule.  

Maxillofacial Surgeon & Implantologist Dr. S. M. Balaji is highly skilled at augmenting jaw bone to facilitate implant placement for complete dental rehabilitation. A Digital X-ray was taken to evaluate the extent of bone deficit. The height of teeth bearing portion of upper jaw bone in the posterior region was inadequate. To compensate the vertical bone deficiency, a bone graft was taken from the retromolar region (region behind the third molar teeth in lower jaw) and secured to the deficient region using the implants themselves.  

Following osseointegration of the implants to the surrounding bone, ceramic crown prosthesis will be given to completely replace form and function of the missing teeth. 

Surgical correction of nose deformities also known as the “Nose Job” requires expertise and experience.  The surgeons estimate the type of defect - either excess or deficit of the height, deviations, depressions, slants and abnormally angled noses. The patient’s expectation of his/her nose is understood after careful examination.

Shown is a case with of a deficiency of the bridge portion of nose. Note the midlevel of the nasal bone, where there is a deficiency creating a huge impact on the patient’s facial profile. This gives the nose a saddle-shape. Maxillofacial Surgeon Dr. S.M. Balaji planned a closed rhinoplasty technique wherein the surgical approach is through the nose to prevent unsightly scars.

Appropriate measurement of nose was made and the amount of augmentation needed was noted. Autologous graft (rib graft) was harvested, shaped and positioned to improve the aesthetics of the nose. The patient was very happy with the surgery outcome and her enhanced appearance. 

A boy born with cleft lip and palate was previously operated for lip and palate defect with pre-maxillary setback and alveolar reconstruction using rhBMP-2. The boy now 11 years old reported to our hospital seeking specialized treatment for his nose and lip defect. The central part of his upper lip was very thin and his upper and lower lip did not meet properly. He also had some difficulty in pronouncing certain words. The lip along with the nose defect affected the boy’s appearance.

Maxillofacial Surgeon Dr. S.M. Balaji performed a combined procedure to correct the nose and lip defect in a single surgery.

The sides and tip of the nose were reshaped by reconstructing the cartilage and skin that attached the nose to the upper lip. Surgical reconstruction of the upper lip was done using a technique called Abbe-Flap. The measurement of the upper lip defect was noted & a flap of tissue of the same size was taken from the lower lip and sutured to the central portion of the upper lip in such a way that the base of the flap was still attached to the lower lip. With this technique, skin, muscle, mucosa, blood vessels, even hair follicles to facilitate growth of moustache, were transferred from the lower to upper lip. After 2 weeks, the flap will be divided and precise form and function will be restored to the upper lip.  

We will update this page soon with photographs showing postoperative results after flap division.  

A 16-year-old boy reported to our Hospital requiring cosmetic correction of his ear defect. The visible external portion (pinna or auricle) of his left ear had a massive button-holing defect.

Maxillofacial Reconstructive Surgeon Dr. S.M. Balaji successfully performed the ear reconstructive surgery using the specialized Island flap. The region behind the ear was marked. The edges of the button holing were cut. The Island flap was raised from behind the pinna and sutured to close the defect.