Ms. Jasra is a 5 year old girl who presented to Dr. S. M. Balaji with craniosynostosis with left plagiocephaly.  This had resulted in her having a deformed head.  Plagiocephaly by definition is flattening of one part of the skull, which leads to facial deformity. She had previously undergone cranial/frontal bone reconstruction and orbital rim advancement elsewhere.
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Craniofacial Surgeon Dr. S. M. Balaji decided to proceed with a craniostomy with calvarial reconstruction to correct her deformity. Customized 3-D stereolithographic models were used for presurgical planning.

She underwent the cranial vault reconstruction surgery on October 24, 2016, at Balaji Dental and Craniofacial Hospital, Chennai by Dr. S. M. Balaji as part of the preconference live surgical demonstration prior to the 10th World Cleft Lip, Palate, and Craniofacial Congress.  Dr. Balaji used sonic weld bioresorbable plates for rotation and advancement of the frontal bone complex. This is an essential surgery because not doing this surgery would result in compromise of brain development, which would lead to decreased mental acuity, vision problems, and many other cranial functions.  Sonic weld plates were used instead of titanium plates because they resorb over time thus facilitating normal bone growth and brain development as opposed to the permanent titanium plates, which would require another surgery for their removal.

The parents expressed their appreciation of how Dr. S. M. Balaji was helping in transforming Jasra’s life for the better. Jasra would need facial asymmetry corrective surgeries at a later date.

A 26 year old woman reported to our hospital with the complaint of swelling in the right side of her face. She added that the swelling was increasing in size dramatically and the lower anterior teeth are mobile teeth. She was very cautious about this progressive swelling which made her under huge depression.
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After thorough clinical and radiological examination, Maxillofacial Surgeon Dr. S. M. Balaji diagnosed ameloblastoma extending from right side of the body of the mandible till the other side. Surgery was planned to remove the lesion and reconstruct the affected jaw portion in a single stage. Through gingivomucoperiosteal flap, complete removal of the lesion along with the involved teeth with sufficient clearance of the bone was done under General anesthesia.  Costochondral rib graft was harvested and fixed to it. Flap was approximated and sutured. Patient was happy to have both removal and reconstruction in a single surgery.

A 27-year-old man from Kolkata reported to our hospital seeking expert craniofacial reconstruction. He had met with a vehicular accident few months back and suffered fracture of the forehead, cheek bones & lower jaw. He underwent initial surgery elsewhere. He had a gross skull defect with a depression in his left forehead. He also complained of continuous tears running down his face from his left eye.

3D CT scan revealed fracture of the frontal bone on the left side. Due to the traumatic injury, a defect in the nasolacrimal duct caused epiphora or abnormal tear flow. The normal flow of tears from the eye to the nose was damaged.

Craniofacial surgeon Dr. S.M. Balaji skillfully performed the complex reconstruction. A cortical bone graft was harvested from the rib and used to reconstruct the left forehead. Miracle protein rhBMP-2 was placed on the bone graft to stimulate new bone formation.

The defect in the nasolacrimal duct was corrected with DCR or Dacryocystorhinostomy. The ostium was opened with rongeurs, bone adjacent to nasolacrimal sac was removed. A new direct communication was created between the nasolacrimal sac & the nasal mucosa by placing a silicone tube to enable the tears to drain into the nose. Complete craniofacial defect was corrected successfully.