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.
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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.

​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. 

A 26-year-old girl reported to our hospital seeking to correct the appearance of her nose. Her nose was much flat and she wanted to have a sharp nose to improve her appearance.
Maxillofacial surgeon Dr. S. M. Balaji expertly performed the augmentation rhinoplasty. A costochondral cartilage graft was harvested and used to reconstruct the depressed dorsum of the nose. The surgery was done from inside the nose (closed rhinoplasty) so there is no scarring. The patient is very happy to have a sharp, defined & pristine nose immediately after surgery, which improved her appearance. 

A 24 year old girl reported to our hospital seeking cosmetic correction of her nose. She had undergone nose correction operation elsewhere to correct her crooked nose shape and blocked nose but they had used open rhinoplasty technique which resulted in an unsightly scar. She was not at all satisfied with the results. She felt the dorsal surface of her nose was flat which gave her an aged look. She wanted to correct her nose profile cosmetically.
Maxillofacial Surgeon Dr. S. M. Balaji planned to correct her flattened nose by following closed augmentation rhinoplasty. Costochondral rib graft was harvested which was used to augment the dorsum of nose. To prevent scarring, the graft was inserted through intranasal approach. Enlarged turbinates were also trimmed. Results are immediate, patient is very happy to have a sharp, pristine nose without any surgical marks, which suits her facial profile. Also she is happy that she no longer has blockage of the nose and can breathe easily.

A 25 year old male reported to our hospital with the complaint of depressed nasal bridge and broad base of the nose with bulky tip of the nose.
Maxillofacial Surgeon Dr. S.M. Balaji corrected his nose by following Augmentation Rhinoplasty technique. Cartilage graft has been harvested and sculpted for the correction of depressed nasal bridge. The surgery was done within the nose so there are no scars on the face. Asymmetrical alar shape was corrected by adjusting the shape of it using harvested rib cartilage.  Results are immediate and he is happy to have a renewed confidence to have a pristine nose with a new, improved look.

​A 23-year-old girl came to our hospital seeking to correct her nose and chin defect. Her chin was very retruded and the tip of her nose was very bulky. She was very self-conscious about her appearance and wanted to improve her facial features.
Maxillofacial Surgeon Dr. S.M. Balaji successfully performed a combined nose and chin correction. Advancement genioplasty was done to correct the retruded chin. The chin bone was sectioned, brought forward and fixed in a more balanced position. The bulbous nose tip was corrected with reduction rhinoplasty.  Foot plate of the medial crus and lower lateral nasal cartilages were removed giving the nose a more slender and sharp. With these combined procedure the patient was very happy to have a more enhanced facial profile without any surgical scars. 

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. 

A 25 year old lady reported to our hospital with the complaints of broad flattened nose. She was very particular to have the cosmetic nose correction without any scars.

Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected her nose by following reduction rhinoplasty technique. Intranasally lower lateral nasal septal cartilage was removed to reduce the bulky nose tip and lateral osteotomy was performed. Results are immediate and patient was happy to have pristine nose correction done without any surgical marks on her face. 

A 16-year-old girl from Chennai was brought to our hospital by 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. A costochondral rib graft was harvested and used to augment the dorsum of the nose. The collapsed left nostril was reconstructed with a strut graft. The surgery was done from inside the nose so there were no scars. Lip revision was also done simultaneously. Immediately following surgery, the girl’s appearance improved greatly and she was very happy with the surgery outcome.

A 25-year-old man reported to our hospital seeking to correct the shape of his nose. His nose was disproportionately large and bulky that affected his appearance. He sought to enhance the appearance of his nose for a more pleasing look.

Maxillofacial surgeon Dr. S.M. Balaji successfully performed the reduction rhinoplasty to reduce the size of the nasal framework. A horizontal, medial & lateral osteotomy was performed to reduce the nose height along with weir excision for narrowing the alar base. The surgery was done from inside the nose to avoid scarring. Immediately following surgery the nose appeared sharp & proportionate greatly enhancing the facial appearance.

A 20-year old man reported to our hospital seeking to correct the shape of his nose. His nose was very elongated that gave the face an unattractive appearance.

Maxillofacial surgeon Dr. S.M. Balaji successfully performed the rhinoplasty to enhance the appearance of the nose. The caudal end of the alar cartilage was reduced. Also the length of the septum and vestibular mucosa were reduced and the nose was shortened. The procedure was done from inside the nose to avoid scars. Immediately following rhinoplasty, the nose now made proportionate & sharp greatly enhanced the facial appearance & the patient was very happy to have a more attractive, scarless look.

A 35-year-old woman reported to our hospital seeking to improve the structure of her nose to improve her facial appearance. The bridge of the nose was depressed and appeared excessively concave in the profile view. Also the tip of her nose was very stout & bulky. 

Maxillofacial surgeon Dr. S.M. Balaji successfully performed the augmentation rhinoplasty. A costochondral cartilage graft was harvested from the rib and used to reconstruct the depressed dorsum of the nose. Excessive fat was removed from the nose tip to make it proportionate & pristine. The procedure was done inside the nose so there was no scar. Following rhinoplasty, the patient was very happy to have a sharp, defined nose making her face more attractive. 

A 22 year-old girl reported to our hospital seeking to correct the shape of her nose. Her nose was broad, flattened and appeared humped in the profile view. She wanted a more attractive nose that would enhance her appearance.

Maxillofacial Surgeon Dr. S.M. Balaji skillfully performed the augmentation rhinoplasty. A costochondral cartilage graft was harvested and used to reconstruct the deformed dorsum of the nose. The graft was placed from inside the nose so there was no scarring. The nose was made sharp, defined and pristine which greatly enhanced her facial appearance. The girl was very happy with the surgery results. 

A 20-year-old man reported to our hospital seeking to correct the appearance of his nose. His nose was much flattened in the middle and he wanted to have a sharp nose to improve his appearance.

Maxillofacial surgeon Dr. S.M. Balaji expertly performed the augmentation rhinoplasty. A costochondral cartilage graft was harvested and used to reconstruct the depressed, collapsed dorsum of the nose. The surgery was done from inside the nose (closed rhinoplasty) so there was no scarring. The patient was very happy to have a sharp, defined & pristine nose immediately after surgery, which improved his appearance.