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

Successful correction of disproportionately long lower jaw without any scars

27/6/2016

A 26 year old man reported to our hospital seeking to correct his long lower jaw. This gave him an aged appearance and he was not happy with his facial profile.

Maxillofacial Surgeon Dr. S. M. Balaji expertly planned to correct his lower jaw protrusion by using bilateral sagittal split osteotomy technique (Obwegeser sagittal Split osteotomy). Intraorally a cut was made bilaterally in the lower jaw bone in the ramus region, excess bone was removed and the segment was set back to its correct position and thus correct dental occlusion was achieved. Results are immediate and the patient was happy to have his lower jaw bone correction done without any scars on the face. His profile also improved dramatically giving him a renewed confidence.

Preoperative facial view showing long face with disproportionately large lower jaw

Profile view showing disproportionately long lower jaw giving asymmetric appearance

Intraoral view showing reverse bite

Complete reverse bite with midline shift

Intraoperative view - Sagittal split on right side

Intraoperative view - Sagittal split on left side

Mandibular nerve traced from foramen ovale and saved

Excess bone removed from buccal cortex to setback the mandible

Excess bone separated from mandible to correct the length

Bone plates fixed to stabilize the segments after achieving proper occlusion

Proper occlusion achieved and segemnts stabilized with bone plates

Corrective jaw surgery and augmentation genioplasty to enhance facial appearance

7/5/2016

A 26 year old boy visited our hospital seeking for correction of his facial profile to enhance the appearance. He was under orthodontic treatment for past 2 years elsewhere. But he was not satisfied with the results and thus he wants to have surgical correction of his jaw without any scars on the face.

After thorough clinical and radiological examination, Maxillofacial Surgeon Dr. S.M.Balaji planned to correct his face by following corrective jaw surgery. He has short upper lip due to vertical maxillary excess which was corrected by Lefort I osteotomy. His profile shows short chin giving round face appearance. This was corrected by augmenting the genium using costochondral rib graft. Thus entire surgery was done inside the mouth and his facial appearance improved dramatically. Patient feels very happy to have the entire facial correction in a single surgery and without any visible surgical marks on the face.

Preoperative facial view showing short lip and retruded chin

Preoperative profile view showing short chin and prominent maxilla

Preoperative digital lateral cephalogram showing protruding maxilla and retruded chin

Costochondral rib graft harvested to augment the genium of mandible

Harvested rib graft used to augment the chin

Lefort I osteotomy done for upper jaw

Symphyseal region prepared to receive costochondral graft

Rib graft prepared to augment the chin

Rib graft prepared

Harvested costochondral graft used to augment the symphyseal region of mandible

Postoperative view showing enhanced appearance without any scars on the face

Postoperative profile view showing augmented chin and corrected profile

Postoperative digital lateral cephalogram showing augmented genium and corrected maxilla

Successful repair of ear tear and lower jaw fractures

1/6/2015

A 38-year-old man had met with a motor vehicular accident in which he had sustained severe injuries to his right ear and lower jaw. His right ear was severely torn causing him great pain and he had much difficulty opening and closing his mouth.

A 3D CT scan showed right and left body of mandible fracture. Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the reconstructive surgery. The mandibular fractures were fixed with bone plates and screws. The ear tear extended from behind the ear at the side of the neck, completely splitting the pinna till the skin of the preauricular region. The scar tissues were excised; the cut pinna was closely approximated and sutured restoring normal form and function. Following suture removal the right ear had a normal appearance and the man was very happy to have his injuries treated successfully.

Severe cut wound in right ear due to trauma

Immediately after suturing

Immediately after suture removal following seven days of surgery showing complete correction of ear

Flat nose and disproportionate jaw correction without any scars on the face

21/5/2015

A 22 year old girl reported to our hospital wanting to correct her nose profile which was very broad and flat to her face and ill-defined dorsum gave her more aged appearance. On addition her prominent upper jaw on side view gave unsightly appearance. Due to her defective nose profile and disproportionate jaw alignment she was very self conscious about her appearance.

Maxillofacial Surgeon Dr. S. M. Balaji skillfully planned to correct her nose by following Augmentation Rhinoplasty technique. Costochondral graft was harvested from the ribs, shaped and used to reconstruct the nose to increase the height. Thus proper shape of the nose was achieved. Maxillary prominence was also corrected by following Lefort I osteotomy. Entire nose correction was made within the nose (closed rhinoplasty technique); there are no scars on the face. Results are immediate and the patient was very happy to see her enhanced profile of the nose without any scars. This dramatically improved her appearance and self confidence.

Preoperative facial view showing broad flat nose with ill defined nasal bridge

Profile view showing flat nose profile with maxillary protrusion

Costochondral rib graft harvested

Harvested rib graft used to augment the dorsum of the nose

Pristine nose without any visible scars on the face following a week after surgery

Successful treatment of lower jaw fractures sustained in a vehicular accident

5/1/2015

A young man had met with a motor vehicular accident few weeks back in which he had sustained injuries to his lower jaw. He had severe jaw pain and he had great difficulty in biting, chewing, and swallowing.

A preoperative 3D CBCT scan revealed fracture in the right mandibular parasymphysis region and left angle of mandible. Maxillofacial Surgeon Dr. S.M. Balaji successfully fixed and stabilized the fractured segments using stainless steel bone plates and screws. Extreme care was taken to save the mental nerve, since fracture was very close to that of the mental foramen. Accurate occlusion and bite was achieved. Post surgery radiograph showed optimum fracture fixation.

Preoperative digital orthopantomogram showing fractured mandible - right parasymphysis and left angle region

3D CBCT scan showing fracture in right parasymphysis region of the mandible

3D CBCT scan showing fracture in left angle of the mandible

Intraoperative view showing fracture fixation in right side of mandible also protecting the mental nerve from getting caught into fracture line

Fracture fixation in the left angle of the mandible

Postoperative radiograph showing successful fixation and stabilization of fractures immediately after surgery

Correction of defective upper jawbone with internal maxillary distraction osteogenesis

2/1/2015

This is a case of unilateral cleft lip and palate operated elsewhere. His profile view was asymmetric due to defective upper jaw bone which also developed difficulty in speech and chew foods. Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected the defective upper jawbone by using intraoral bilateral maxillary distraction osteogenesis technique following orthodontic treatment to have perfect occlusion postoperatively. Results are immediate and patient is very happy of his improved appearance and to have entire jaw correction done without any scars.

Preoperative profile view showing defective upper jaw due to cleft defect

Intraoperative view showing lefort I osteotomy with bilateral maxillary internal distractor fixed

Intraoperative view showing internal maxillary distractor fixation following orthodontic treatment

Postoperative view following internal maxillary distraction osteogenesis giving enhanced appearance

Corrective jaw surgery (orthognathic surgery) for gummy smile

27/12/2014

A 22-year-old boy came to our hospital for expert correction of his protruding upper jaw. The boy was about to begin his career and he was very self-conscious about his appearance.

Clinical and radiological investigation showed his upper jaw or Maxilla was disproportionately larger as compared to the lower jaw and his upper teeth were severely protruding. Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the corrective jaw surgery or orthognathic surgery with Le Fort I osteotomy. The upper jaw was set back, reshaped & realigned to his perfect facial harmony. The entire procedure was done from inside the mouth so there were no scars. Immediately following surgery the boy’s appearance was greatly enhanced and his more attractive profile boosted his confidence.

Preoperative facial view showing inability to close upper lip due to lengthened upper jaw - short lip

Postoperative view showing enhanced appearance by reducing the length of the upper jaw without any scars

Successful corrective jaw surgery and rehabilitation with implants for patient with complex facial fractures

25/9/2014

A 26-year-old man from Singapore reported to our hospital seeking to correct his bite and replace his missing upper front teeth. He gave a history of having met with a vehicular accident in which he had sustained complex, multiple fractures of the upper & lower jaw, cheek & eye bones and forehead. The fractures were treated elsewhere. Subsequently he developed an incorrect bite because the jaw fractures were not fixed in proper occlusion.

Maxillofacial Surgeon Dr. S.M. Balaji removed the bone plate from the lower jaw and successfully performed an Obwegeser sagittal split osteotomy realigning the lower jaw in accurate relation with the upper jaw to correct the bite. Dental implants were placed in the missing teeth region of the upper front jaw. Later ceramic crowns will be fixed to the implants to complete the dental rehabilitation.

Simultaneous corrective jaw surgery and cosmetic nose correction without any scars

19/9/2014

A 30 year old man from USA reported to our hospital seeking correction of his facial appearance. He was not happy with his broad flattened nose and upper jaw prominence giving him more aged appearance. He wanted to have cosmetic correction of his nose and jaw without any surgical marks on his face.

After thorough clinical and radiological examination, Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected his nose and jaw simultaneously by following anterior maxillary excess removal along with subapical osteotomy for lower jaw and dorsal augmentation of the nose with costochondral graft via intraoral approach. Results were immediate. Patient was very happy to have an improved appearance and that his nose and jaw correction was done concurrently without any surgical marks on his face.

Preoperative view showing broad flattened nose

Preoperative profile view showing flattened nose with protruding upper jaw

Maxillary excess removal done and augmentation rhinoplasty using costochondral grafting performed

Postoperative view showing reduced size of the nose with maxillary prominence correction

Postoperative view showing corrected nose profile with proportionate upper and lower jaw

Corrective jaw surgery (orthognathic surgery) for gummy smile

25/7/2014

An 18-year-old girl from Bangalore was brought to our hospital by her parents for expert correction of her protruding upper jaw that caused an unattractive “gummy smile”. The girl was about to begin her college education and she was very self-conscious about her appearance.

Her facial bones were analyzed using digital x-rays. Her upper jaw or Maxilla was disproportionately larger as compared to the lower jaw and her upper lip was short causing too much of the gums to be visible while smiling. Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the corrective jaw surgery or orthognathic surgery with Le Fort I osteotomy. The upper jaw was set back, reshaped & realigned in perfect facial harmony. The entire procedure was done from inside the mouth so there were no scars. Immediately following surgery the girl’s appearance was greatly enhanced and her more attractive, pleasing smile boosted her confidence.