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

Cleft Rhinoplasty, Lip Revision and Alveolar Bone Graft Surgery

6/12/2020

This young man was born with a unilateral cleft lip and palate deformity, which was surgically corrected as an infant. He presented to our hospital stating that he wanted correction of his nasal deformity as well as the hypertrophic lip scar.

Examination revealed a noticeable depression in the right anterior maxillary region, which caused the right nostril to be depressed. He also had a flattened nasal bridge and a hypertrophic scar on his lip.

The depression in his right anterior maxilla was addressed using bone grafts harvested at the time of surgery. A costal graft was then utilized to augment the bridge of his nose. This was followed by a lip scar revision surgery as well as a Weir excision for left alar base correction.

This resulted in a symmetrical nasal form and he was very happy with the results of the surgery. He profusely thanked the surgical team before final discharge from the hospital.

Surgery Video

Cleft rhinoplasty without scars

26/8/2016

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

Successful cleft nose and lip correction using Abbe flap technique

15/6/2016

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

Cleft rhinoplasty with secondary lip correction without scars

21/5/2016

A 16 -year-old girl reported to our hospital seeking specialized treatment to correct her cleft nose defect. She was previously operated for cleft lip and palate elsewhere. Due to the cleft defect her nose was collapsed on the left side and it affected her facial appearance.
Maxillofacial Surgeon Dr. S.M. Balaji expertly performed the Corrective 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 her nose defect corrected without any visible surgical marks on the face.

Defective nose due to cleft and short upper lip due to incorrect lip repair done elsewhere

Depressed columella of nose and left alar shape was defective due to incorrect primary lip repair

Costochondral rib graft obtained from right side to reconstruct the ala of the nose

Immediate postoperative view showing corrected shape of the nose giving enhanced appearance

Raised columella of nose intranasally also shape of the left ala was also corrected giving symmetrical appearance

Cleft rhinoplasty without scars

28/4/2016

A 26-year-old girl reported to our hospital seeking specialized treatment to correct her cleft nose defect. She was previously operated for cleft lip and palate elsewhere in her childhood. Due to the cleft defect her nose was collapsed on the left side and it affected her 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 her nose defect corrected without any scars.

Cleft nose defect before rhinoplasty

Left side of the nose collapsed due to the cleft defect

Costochondral graft harvested

Immediately after rhinoplasty-nose made sharp and defined without scar on the face to enhance appearance

Immediately after rhinoplasty-collapsed nostrils were successfully corrected and reconstructed without scars

Cleft rhinoplasty for reshaping nose without scars

15/2/2016

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

Reduction rhinoplasty for cleft nose with lip revision

5/2/2016

A 22-year-old girl came to our hospital with her parents for expert correction of her cleft nose & lip defect to enhance her appearance. Her nose was flattened and collapsed on the left side and there was an unsightly scar on the lip which affected her appearance. She was previously operated elsewhere for her unilateral cleft lip and palate in her childhood.

Maxillofacial Surgeon Dr. S. M. Balaji successfully performed the cleft rhinoplasty & cleft lip revision. Intranasally lower lateral nasal septal cartilage was removed. The surgery was done from inside the nose so there were no scars. Secondary cleft lip revision was also done and missing left upper lateral incisor tooth was replaced with dental implant. Immediately following surgery, the girl’s appearance improved greatly and she was very happy with the surgery outcome.

Preoperative view showing broad nose with asymmetrical ala and defective lip due to cleft

Bulky tip of the nose with asymmetrical nostrils

Intraoperative view showing implant fixed in the missing tooth region with good stability

Lower lateral nasal septal cartilage was removed intranasally

Immediate postoperative view showing corrected tip of the nose and symmetrical ala without any visible surgical marks

Corrected tip and nostrils shape with secondary cleft lip revision

Cleft rhinoplasty without scars - BALAJI DENTAL

27/6/2015

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

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

8/6/2015

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

Cleft rhinoplasty without scars - Dr. S.M Balaji

5/5/2015

A 15-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. 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. 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

Successful cosmetic cleft rhinoplasty and secondary cleft lip repair

31/12/2014

A 20 year old boy came to our hospital seeking cosmetic correction of his cleft nose and lip defect which was previously operated elsewhere. He was very particular to have both nose and lip correction done at the same time to improve his appearance.

After thorough clinical and radiological examination, Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected his buckled ala of cleft nose defect by removing the deviated nasal septal cartilage intranasally and secondary cleft lip repair done to align the vermillion of upper lip perfectly. Results are immediate and nose symmetry achieved. Patient was very happy to have both lip and nose correction at the same surgery without any surgical marks.

Buckled ala of nose on the right side and incorrect primary cleft lip repair

Immediate postoperative view showing symmetrical nose and corrected lip defect giving pristine appearance

Rhinoplasty for correction of cleft nose defect

11/11/2014

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

Rhinoplasty for correction of nose defect in unilateral cleft

6/11/2014

A 23 year old man reported to our hospital seeking to correct his nose defect. He was previously operated for unilateral cleft lip and palate elsewhere. Also he had undergone multiple surgeries elsewhere to correct his nose defect but they were unsuccessful. Patient was very conscious about his facial appearance.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the rhinoplasty to enhance the appearance of the nose. Nasal septal graft was harvested. Bent nasal septum was straightened using the graft as batten and the collapsed alar rim was reconstructed. Immediately following surgery the nose appeared more symmetric and the facial appearance was enhanced greatly. The patient is very happy with the surgery outcome.

Reduction rhinoplasty & lip revision for improved aesthetics in cleft patient

29/9/2014

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

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

5/9/2014

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

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

Simultaneous correction of unilateral cleft nose and prognathic lower jaw

17/6/2014

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

Augmentation rhinoplasty with good results for bilateral cleft lip palate patient

7/6/2014

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

Severely constricted external nostrils correction in cleft nose

5/6/2014

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.

Preoperative view showing depressed ala of the nose towards left side

Preoperative view showing illdefined alar base on left side due to cleft defect

Depressed nasal bridge giving flattened nose profile

Nasolabial flap marked to reconstruct the ala of the nose

Nasolabial flap was raised to reconstruct the left ala of the nose

Costochondral graft harvested to enhance the dorsum of the nose

Results are immediate and alar base reconstruction done without scars

Immediate postoperative view showing nasal tip aligned and ala of the nose was raised resulting in symmetrical appearance of the nose

Postoperative profile view showing enhanced appearance of the dorsum of the nose

Defective cleft lip and nose correction using prolabium and Abbe flap technique

4/6/2014

A 12 year old boy with bilateral cleft lip and palate reported to our hospital with the complaints of defective upper lip and ill-defined nose tip with depressed nasal bridge. His parents were not happy with the boy’s appearance and he was not able to spell few words due to defective upper lip which made him more depressed.

Maxillofacial Surgeon Dr. S. M. Balaji skillfully planed to correct his upper lip defect as well as his ill- defined tip of the nose by following Abbe flap technique. Surgery was done in two stages. In the first step, prolabium was raised to increase the columellar length and nasal tip projection. And the cleft lip defect was corrected with Abbe flap technique were lower lip tissue was raised and attached to the upper lip defect region. In the second step, achieving good healing after 25 days the upper and lower lip was surgically separated and thus nose as well as lip defect correction was done simultaneously without many surgical scars. The boy and his family was very happy to see the enhanced appearance of the nose and well aligned upper and lower lips without any surgical scars.

Pre operative view showing very thin upper lip and flattened nose defect in a cleft child

Pre operative profile view showing over stretched upper lip with depressed nasal bridge and ill-defined tip of the nose

During procedure - Prolabium was raised to increase the colmellar length and nasal tip projection

Abbe flap technique- flap taken from lower lip and used to reconstruct defective upper lip

In the second stage, Abbe flap was divided and upper and lower lip was separated

Immediate post operative view showing improved profile appearance after nose & lip reconstruction