Category: Cleft Nose

Cleft nose correction for improved esthetics & function

19/1/2017

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Preoperative view showing depressed right ala of nose and nasal base due to cleft defect

Worm's eye view showing distinguished depression of right nasal base

Dr. S. M. Balaji operating on the patient

Intraorally nasal base augmented using bone graft

Immediately after suturing

Immediate postoperative view showing corrected nasal base and symmetric appearance without any visible surgical marks on the face

Columellar view showing corrected level of nasal base without any visible scars on the face

A young man born with unilateral cleft lip and palate reported to our hospital seeking expert correction of his nose deformity. Earlier Dr. S. M. Balaji has done cleft alveolar repair using bone protein rh-BMP2 and pharyngoplasty.
On examination, lower lateral cartilage on the cleft affected side was buckled & depressed affecting his appearance and breathing and distinguished nasal base depression due to lack of bone.
Maxillofacial Surgeon Dr. S. M. Balaji successfully performed the cleft rhinoplasty or nose correction procedure employing bone graft obtained from right iliac crest. Following surgery, the overall facial profile and breathing improved remarkably.

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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 cleft nose and lip correction using Abbe flap technique

15/6/2016

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A 16 year old boy born with bilateral cleft lip and palate came to our hospital for expert cleft treatment. He was operated elsewhere for primary cleft lip and palate. He had a thin upper lip and broad flattened nose for which he 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 was 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 view showing broad flat nose with defective upper lip

Profile view showing ill defined columella of nose with depressed nasal tip and defective upper lip

Columellar view showing ill defined columella and depressed dorsum of nose with defective upper lip

Immediately after suturing showing raised defined dorsum with corrected lip alignment

Postoperative profile view showing enhanced appearance

Postoperative view showing enhanced appearance of nose and lips without much visible scars on the face

Postoperative profile view following 1 week after suture removal showing enhanced appearance

Columellar view showing corrected dorsum and alar shape with defined columella of nose

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Cleft rhinoplasty for reshaping nose without scars

15/2/2016

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A 22-year-old girl came to our hospital wanting to correct the shape of her nose to improve her appearance. She was born with cleft lip and palate for which she was treated elsewhere in her childhood. Now her nose appeared asymmetric, misshapen & flattened and the nostrils appeared collapsed, which made her look unattractive. She was very depressed about her facial appearance.

Maxillofacial Surgeon Dr. S.M. Balaji performed the cleft rhinoplasty to correct the nose shape. Rib graft was taken and used to raise the base of the nose through an intraoral approach. Also the height of the columella was increased and the graft was used to reconstruct the alae and nasal dorsum. Immediately following surgery the nose appeared sharp, symmetrical and pristine greatly improving her appearance. The girl is very happy to have an attractive look without any scar.

Preoperative view showing defective nose in the right side due to cleft defect

Profile view showing depressed dorsum of the nose

Depressed ala of nose on the right side due to cleft alveolar defect

Harvested costochondral rib graft to reconstruct the nose

Immediate postoperative view showing symmetrical ala of the nose without any visible surgical marks on the face

Profile view showing augmented dorsum of the nose

Columellar view showing raised dorsum of the nose with corrected columellar defect intranasally

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Cleft rhinoplasty without scars - BALAJI DENTAL

27/6/2015

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A 22-year-old boy reported to our hospital seeking specialized treatment to correct his cleft nose defect. He was previously operated for cleft lip and palate elsewhere in his childhood. 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 expertly 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. 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 scars.

Facial view showing flat ala on the left side due to cleft defect

Flat dorsum with depressed columella due to cleft defect

Depressed columella with alar defect due to cleft deformity

Harvested costochondral rib graft used to augment the dorsum of the nose

Immediate postoperative view showing corrected alar defect

Corrected profile view showing augmented dorsum of the nose

Corrected alar shape with nostrils and columellar length raised without any visible scars on the face

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Nose correction & Abbe flap procedure for lip correction in cleft patient

8/6/2015

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A 25-year-old man came to the hospital wanting to correct his lip and nose defect to improve his appearance. He was born with bilateral cleft lip and palate which was previously operated elsewhere. His upper lip was very thin and his nose appeared deformed making him very self-conscious about his appearance.

Maxillofacial Surgeon Dr. S. M. Balaji successfully performed an abbe flap procedure for lip correction and nose correction. A flap of tissue was taken from the lower lip, rotated across the mouth and used to reconstruct 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. Once blood supply was established, the flap was divided giving the upper lip a more natural, improved form. The broad nose was reshaped to make it more proportionate and balanced. Following surgery the man was very happy to have an improved facial 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

Immediately after suturing with columella enhancement and upper lip correction

Immediately after suture removal following 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

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Successful cleft nose and lip correction with Abbe flap

9/5/2015

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A 22 year old boy born with bilateral cleft lip and palate came to our hospital for expert cleft treatment. He was operated elsewhere for primary cleft lip and palate. He had a thin upper lip and broad flattened nose for which he 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 view showing broad flat nose with defective upper lip

Profile view showing ill defined columella of nose with depressed nasal tip and defective upper lip

Intraoperative view showing raised columella of nose and correction of upper cleft lip defect

Immediately after suturing showing corrected nose and lip defect using Abbe flap technique

Postoperative profile view showing raised dorsum of nose with nasal tip giving pristine appearance

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Successful cleft nose and lip correction with Abbe flap

25/3/2015

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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

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Successful cleft nose and lip correction with Abbe flap

7/1/2015

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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

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

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Rhinoplasty for correction of cleft nose defect

11/11/2014

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A girl with unilateral cleft lip and palate came to our hospital seeking to correct her nose defect to enhance her appearance. She was previously operated elsewhere for cleft lip and palate defect. Her nose appeared collapsed on the right side and the asymmetry gave an unpleasant look.

Maxillofacial Surgeon Dr. S.M. Balaji successfully corrected her nose defect with rhinoplasty surgery. A columellar strut graft obtained from costochondral rib was used to reconstruct the collapsed ala of nose. The deviated nasal dorsum was corrected with lateral osteotomy giving an enhanced, symmetric appearance. Immediately following surgery, the nose appeared reshaped and defined giving the face a more attractive appearance.

Preoperative view showing deviated dorsum of the nose and depressed alar towards left side due to cleft defect

Preoperative view showing collapsed right alar base and shape of the nose due to unilateral cleft defect

During procedure columellar strut graft harvested from the rib and shaped and adapted to the ala of the nose

Postoperative view showing correction of the deviated dorsum of the nose and reconstructed shape and size of the ala of the nose

Postoperative view showing corrected alar base and shape of the ala of the nose without much surgical marks

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Reduction rhinoplasty & lip revision for improved aesthetics in cleft patient

29/9/2014

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A 25-year-old man reported to our hospital seeking to correct his cleft nose defect and lip scar to improve his appearance. He was previously operated elsewhere for cleft lip and palate. He had an unsightly scar of the cleft lip repair. His nose appeared bulky and deviated. Also the large, unpleasant hump of the nose affected the facial profile making his face unattractive.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed reduction rhinoplasty to decrease the overall bulk of the nose and to correct septal deviation. The lower lateral nasal septal cartilages were removed. Medial and lateral osteotomy was done with dorsal hump reduction. Cleft lip scar revision was also done. Immediately following surgery the nose appeared more proportionate and sharp. The nose profile appeared smoother & reshaped. This along with the revised lip scar greatly enhanced the facial appearance. The man was very happy with the surgery outcome and to have a more pleasing appearance.

Preoperative view showing bulky nose with deviated nasal tip

Preoperative profile view showing typical parrot beak appearance

During procedure deviated portion of nasal septal cartilage was exposed

Deviated caudal portion of nasal septal cartilage was removed intranasally

Medial osteotomy done to reduce the nasal hump and bulkiness of dorsum of the nose

Immediate postoperative view showing reduced bulkiness with deviated nasal septal correction without any surgical marks

Postoperative view showing corrected nose profile giving pristine appearance for his face

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Simultaneous correction of unilateral cleft nose and prognathic lower jaw

17/6/2014

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A 15 year old boy with unilateral cleft lip and palate reported to our hospital with the complaints of asymmetrical nose and depressed nostril on the right side due to huge cleft defect. And he wants to correct his jaw alignment where the lower jaw is prognathic due to which he was not able to bite and chew any hard food stuffs. Defective nose profile reduced his self confidence considerably.

Maxillofacial Surgeon Dr. S. M. Balaji skillfully planned to correct his cleft nose defect as well as the jaw alignment simultaneously. Cleft nose defect was corrected with columellar strut graft harvested from the ribs, through intraoral approach and shape of the ala was maintained. Also alar base was raised with the graft.

Skeletal malocclusion correction was done by subapical osteotomy and thus skeletal cross bite was corrected. Patient and his parents were happy to have both the defective nose and bite correction done simultaneously without any scars on the face. Results are immediate.

Preoperative view showing depressed right alar base due to huge cleft defect

Preoperative intraoral view showing reverse bite due to restricted growth of upper jaw

Costochondral graft harvested to correct the nose defect

Depressed ala of the nose was shaped with the harvested chondral graft

Through intraoral approach alar base was raised with the graft and cleft defect was corrected

Postoperative view showing corrected alar base and ala of the nose

Postoperative occlusal view showing enhanced bite with proper overjet and overbite

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Augmentation rhinoplasty with good results for bilateral cleft lip palate patient

7/6/2014

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An 18-year-old boy reported to our hospital seeking to correct his cleft nose defect that affected his appearance. He was operated elsewhere in his childhood for bilateral cleft lip and palate. Due to the cleft defect his nose was deformed and beak shaped.

Maxillofacial surgeon Dr. S.M. Balaji skillfully performed the cleft rhinoplasty. A costochondral cartilage graft was harvested and the dorsum of the nose was augmented using the graft. The prominent lower lateral nasal cartilage was removed on both sides to correct the ala defect and reconstruct the structure of the nostrils. The surgery was done from inside the nose so there was no scar. Immediately after surgery, the nose appeared sharp and defined and the boy was very happy with the scarless results.

Preoperative view showing defective nose due to bilateral cleft lip and palate giving double nose appearance

Profile view showing dorsum defect

Costochondral cartilage graft harvested

Dorsum of nose augmented using graft and nostrils reshaped to enhance appearance without scars

Nose reshaped & improved profile appearance after rhinoplasty without any scars

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Severely constricted external nostrils correction in cleft nose

5/6/2014

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A 30-year-old woman reported to our hospital seeking expert treatment to correct her nose deformity to improve her appearance. She was previously operated elsewhere for unilateral cleft lip & palate. Also nose correction was done elsewhere but the results were esthetically disappointing and excessive contraction of the scar led to severe constriction of the left external nostrils. Her flattened nose was collapsed on the left side making her face look unattractive.

Maxillofacial surgeon Dr. S.M. Balaji skillfully performed the rhinoplasty. A nasolabial flap was raised and used to reconstruct the severely constricted external nostrils by shaping the left ala of the nose. A costochondral rib graft was harvested and used to reconstruct the dorsum giving the nose a sharp, defined form. Following surgery, the patient was very happy with her enhanced appearance without any scars on the face.