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

Bilateral Cleft Lip Surgery

22/3/2021

0 Comments

 
Picture
This little girl had a congenital bilateral cleft lip and palate deformity. Her parents were counseled regarding her cleft deformities at the time of her birth.

She was brought to our hospital for surgical correction when she was 8 months old. Her bilateral cleft lip deformity was addressed first. She had a very wide cleft with a mobile premaxilla. Her prolabium was also very tiny along with a very short columella. There was also very minimal tissue for reconstructing the lip.
​
She underwent a single stage repair utilizing Paul Black’s technique. No cross incision was made at the prolabium. Available prolabium and columella were utilized for reconstructing the philtral column and Cupid’s bow.

This was followed by creation of the nasal floor and vermillion. Bilateral C-flaps were utilized for this. Extreme care was taken as there was very minimal tissue available. This was followed by meticulous three layer closure of the cleft lip under loupe magnification. Orbicularis oris muscle was approximated at the midline. This was followed by approximation of the subcutaneous tissue and skin.
Her parents were extremely happy with the results of the surgery.
0 Comments

Successful surgical correction of retruded maxilla due to BCLP

19/2/2019

0 Comments

 

A girl with BCLP

This is a 19-year-old female from Bhopal. She has a known history of bilateral cleft lip and palate. She had undergone multiple surgeries for cleft lip repair and palate repair. Alveolar cleft defect reconstruction was also done. All the surgeries were done elsewhere. They have a familial history of cleft lip and palate. It was passed down through generations.

Backwardly placed upper jaw

She presented with a complaint of backwardly placed upper jaw. This gave her an aged look. She was also unhappy with her face. The patient wanted to have a more pleasing face. She was unable to bite and chew food.

A local dentist had mentioned that her upper jaw was small at a young age. He stated that she will have orthodontic problems in the future. He started noticing the difference when she was in a mixed dentition period. He had suggested that she would require orthognathic surgery at a later age or risk developing jaw joint pain.

He had reviewed her at about 18 years of age. During which he noticed that she did not have a proper bite relationship. The upper and lower teeth were completely malaligned. She had a lot of dental issues. There was also a noticeable anterior crossbite. The roof of her mouth was normal after surgical correction of cleft palate.​
cleft lip surgery india
Pre-operative front view showing complete crossbite
cleft palate surgery india
Immediately after suturing of the anterior vestibular region
maxillofacial surgery india
Post-operative view showing a normal facial profile

Clinical evaluation

​She had an abnormal bite. The upper and lower jaw was in an abnormal position. Every single tooth including the upper molars was also abnormally placed. She had an anterior and posterior crossbite. This is also known as a complete crossbite. The patient had a more curved facial profile. Her profile was concave. This showed that she needed advancement of the maxilla.

Radiological evaluation

​Radiological evaluation revealed backwardly placed upper jaw. This was due to restricted growth of maxilla. The growth of mandible was normal. Since the maxillary jaw growth was restricted, the mandible looked longer. The upper front teeth were placed inside the lower front teeth.

Surgery

​Maxillofacial surgeon Dr.S.M.Balaji advised upper jaw surgery by bringing the maxilla forward.   Maxillary advancement was planned by Le Fort I osteotomy. The segment was to be fixed using Ti plates and screws. An incision made in the maxilla. Flap elevated. Bone cuts made above the apices of the teeth. Pterygomaxillary dysjunction done.  The maxillary segment was mobilized. The maxilla was pulled forward. It was brought in occlusion and fixed using Titanium plates and locking screws (Ti L plate). The maxillary vestibular region was sutured.

Surgical Outcome

​The patient was greatly satisfied with the results. The surgery was successfully performed. The maxilla was successfully brought forward. The anterior crossbite and posterior crossbite was corrected. The patient will, however, require post-surgical orthodontic treatment for minimal teeth alignment.
0 Comments

Surgical correction of  the upper lip and nose defect in bilateral cleft lip and palate patient using Abbe Flap technique

14/11/2017

0 Comments

 
Successful reconstruction of the upper lip attempts to maintain the anatomic and physiological relationship of the philtrum (central portion of upper lip) and the base of the nose.

This is the case of secondary cleft lip and nose deformity in a 22 year old boy from Nepal. He is a known bilateral cleft lip and palate patient where the primary cleft lip and palate surgeries where done elsewhere in his hometown. He had defective appearance of the nose and lip due to which he lost his self confidence and he was very conscious about the appearance.
​
Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected both the nose and lip defect together using Abbe flap technique. In the first stage a flap of tissue was taken from the lower lip, rotated across the lips and used to reconstruct the thin central portion of the upper lip, with the base of the flap still attached to the lower lip. Simultaneously in the same procedure itself, reduction rhinoplasty was done to correct the broad nose. After blood supply was established in a few days, the second stage surgery to divide the flap was done. The defect was corrected giving the upper lip a more natural, enhanced form. Results are immediate, both the nose and upper lip defect are corrected giving improved appearance and this boosted the boy’s confidence.
Preoperative facial view showing defective lip and nose due to bilateral cleft lip and palate
Worm's eye view showing depressed dorsum of nose and ill defined columella
Preoperative profile view showing depressed dorsum of nose with defective upper lip and ill defined tip of the nose
Rib cartilage harvested to reconstruct the dorsum of nose
Immediately after suturing using Abbe flap technique showing improved appearance
Postoperative view immediately after suture removal with the lower lip tissue attached to that of upper lip
3 weeks postoperative view following abbe flap division showing enhanced appearance of the nose and lip
Postoperative columellar view showing corrected nostrils shape and size with raised columella of nose
Postoperative profile view showing raised dorsum and tip of the nose with corrected lip profile
0 Comments

Surgical correction of bilateral incomplete cleft lip

22/9/2017

0 Comments

 
This is a case of 3 months old baby boy with incomplete bilateral cleft lip from Bangladesh. Maxillofacial Surgeon Dr. S.M. Balaji surgically corrected the cleft lip defect by following Paul Black's technique. Results are  immediate. Immediate postoperative view following suture removal shows negligible scar formation.  ​
Bilateral incomplete cleft lip defect in 3 months old baby boy
Immediately after suturing using Paul Black's technique
Postoperative view immdiately after suture removal following seven days after surgery
0 Comments

Bilateral Cleft Lip- Successful Primary Correction

20/1/2017

0 Comments

 
A 3-month-old baby boy born with bilateral cleft lip and palate was brought to our hospital by his parents for specialized cleft lip & palate surgery.
Maxillofacial Surgeon Dr. S.M. Balaji performed the primary cleft lip correction surgery using Paul Black’s technique 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. 
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

Bilateral Cleft Lip- Successful Primary Correction

11/2/2016

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 using Paul Black’s technique 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. 
3 month old baby girl showing bilateral cleft lip and palate defect
Immediate postoperative view showing primary cleft lip repair using Paul Black's technique
Immediately after suture removal following seven days after surgery showing negligible scar
0 Comments

Bilateral Cleft Lip- Successful Primary Correction

19/8/2015

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 using Paul Black’s technique 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. 
3 month old baby girl showing bilateral cleft lip and palate defect
Immediate postoperative view showing primary cleft lip repair using Paul Black's technique
Following 6 months after lip repair surgery showing enhanced appearance of the girl
0 Comments

Successful premaxillary setback and complete closure of huge alveolar cleft using miracle protein rhBMP-2 in a bilateral cleft lip and palate boy

8/4/2015

0 Comments

 
An 8-year-old boy born with bilateral cleft lip and palate reported to our hospital seeking specialized treatment for her cleft defect in the alveolar bone (teeth bearing region of upper jaw). He was previously operated for cleft lip & cleft palate elsewhere.

Due to the bilateral cleft, his maxilla or upper jaw bone was in 3 parts. Anterior segment (premaxilla) was so much forwardly placed. Maxillofacial Surgeon Dr. S.M. Balaji performed the alveolar cleft reconstruction using the miracle protein rhBMP-2 following premaxillary setback. This protein stimulates the body’s own cells to rapidly form new bone at the site of placement. Following surgery, there will be complete bone fill in the cleft defects thereby joining the 3 segments into a single complete maxilla.

By using this revolutionary technology, additional bone graft surgery and scarring at the graft site is avoided. Dr. Balaji has successfully used this novel protein in complete reconstruction of several facial bone defects.
3D CBCT scan view showing detached premaxilla due to cleft defect
During surgery complete separation of premaxilla with that of the maxilla was exposed
Following premaxillary setback alveolar cleft defect was closed with rhBMP2 bone protein
Alveolar cleft defect was corrected by placing miracle bone protein rhBMP2
0 Comments

Successful cleft nose and lip correction with Abbe flap

25/3/2015

0 Comments

 
A 22 year old girl born with bilateral cleft lip and palate came to our hospital for expert cleft treatment. She was operated elsewhere for primary cleft lip and palate. She had a thin upper lip and broad flattened nose for which she sought treatment.

Maxillofacial Surgeon Dr. S.M. Balaji performed the specialized Abbe flap technique to correct the upper lip. A flap of tissue was taken from the lower lip and used to reconstruct the upper lip with the base of the flap still attached to the lower lip. Once blood supply is established, the flap will be divided giving the upper lip a more natural, improved form.

Simultaneously, the broad nose was reshaped to make them more proportionate and balanced. Following surgery, the nose appeared sharp & defined with more proportionate profile.
Preoperative facial view showing defective cleft nose and lip
Preoperative profile view showing depressed nasal tip due to missing columella and missing upper lip prominence
Costochondral rib graft harvested to reconstruct the defective cleft nose
Immediately after suturing
Immediately after Abbe division showing enhanced appearance of nose and upper lip without much surgical marks
Profile view showing augmented nose profile and columella and proportionate lips were obtained giving enhanced appearance
0 Comments

Successful reconstruction of alveolar cleft into a single jaw bone using miracle bone protein rhBMP-2

9/3/2015

0 Comments

 
A 3 year old boy with unilateral cleft lip and palate defect from Bihar was brought to our hospital by his parents for closure of the cleft defect in the teeth bearing region of upper jaw bone. He was previously operated for cleft lip and cleft palate. Due to the cleft defect, upper alveolus was in two parts which will severely affect the development of teeth later.

Maxillofacial Surgeon Dr. S. M. Balaji performed the cleft alveolus closure with rhBMP-2 which helps in uniting the two parts into a single jaw bone with new bone formation. This surgery helped for proper growth and development as well as alignment of his teeth later.  
Preoperative intraoral view showing alveolar cleft defect in left side
Preoperative digital orthopantomogram showing cleft alveolus in left side
Intraoperative view showing alveolar cleft after raising gingivomucoperiosteal flap
rhBMP-2 placed in the alveolar cleft region to induce new bone formation
Immediately after suturing
0 Comments

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

13/8/2014

0 Comments

 
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
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