Category: Plastic Surgery

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

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Broad flattened nose correction without any scars

20/5/2014

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A 25 year old man reported to our hospital with the complaints of broad and flattened nose which gave him an aged appearance. He was not happy with his nose profile.

Maxillofacial Surgeon Dr. S. M. Balaji skillfully planned to correct his nose following Augmentation Rhinoplasty technique with alar base correction. Rib cartilage graft has been harvested and shaped to correct dorsum of the nose. Alar base was corrected by Weir excision technique. Thus surgery was done within the nose (closed rhinoplasty technique); there are no scars on the face. Results are immediate and the patient was very happy to see his enhanced appearance of his nose without any scars. This dramatically improved his profile and renewed his confidence.

Pre operative profile view showing depressed bridge of the nose - saddle nose appearance

Pre operative view showing indistinct columella of nose giving flat and broad appearance

Rib cartilage graft harvested to reconstruct the bridge of the nose

Harvested rib cartilage graft shaped to reconstruct the framework of the nose

Immediate post operative profile view showing enhanced appearance of dorsum of the nose without any scars

Immediately after surgery columella of the nose raised and shape of the alar base corrected by Weir excision

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Rhinoplasty for correction of flattened nose without scars

6/5/2014

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Broad, flattened nose causing unpleasant appearance

Costochondral graft harvested

Nose reconstructed using graft through intranasal approach-nose made sharp & pristine without scars

A 27-year-old girl reported to our hospital seeking expert treatment for her flattened nose. She wanted to improve the appearance of her nose for a more attractive facial profile.

Her nose was board and flat with the middle portion of the nose appearing obscure. Maxillofacial Surgeon Dr. S.M. Balaji expertly performed the rhinoplasty surgery. A costochondral graft was harvested and used to reconstruct the dorsum of the nose. The surgery was approached from inside the nose so there was no scarring on the face. Immediately after surgery, the nose appeared sharp, pristine and overall made the face more attractive. The patient was very happy to enhance her looks without scars.

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Successful reconstruction of facial burn injury using Tissue Expansion technique

7/3/2014

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A 28-year-old electrician came to our hospital seeking expert treatment for his face burn. He had suffered a severe burn injury to the left side of his face, in an accident at his workplace. Elsewhere, a split-thickness skin graft surgery from his thigh was done but the patient was very unhappy with the graft shrinkage and color mismatch.

Maxillofacial Surgery Dr. S.M. Balaji performed the facial reconstruction surgery using the novel “Tissue expansion” technique wherein a device called tissue expander was placed beneath the normal skin on the left cheek. Saline solution was infused into the device regularly. The device gradually expanded, stretching the overlying skin. New, healthy skin was grown at the site locally, of the same color & texture. This skin was used to reconstruct the scarred portion of the left cheek, chin & neck. Since the tissue was grown locally, there was no color mismatch. The wound healed well and his appearance improved drastically