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Fixation of fractured and displaced facial bone intraorally to avoid scar formation

23/12/2014

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A 20 year old boy came to our hospital with the complaint of fractured facial bone on the right side due to vehicular accident.  He was complaining of facial asymmetry due to medial displacement of fractured cheek bone. 

After thorough clinical and radiological examination, Maxillofacial Surgeon  Dr. S.M.Balaji diagnosed fractured right body of zygoma with medial displacement. This led to facial asymmetry. To avoid scar formation, intraorally through sulcular incision fractured zygoma was exposed, elevated and fixed using 4 hole titanium bone plate. This improved his appearance dramatically.  Patient was very happy to have fractured facial bone fixation without any surgical marks. 
Preoperative 3DCT scan showing right body of zygoma fracture and its medial displacement
Fractured zygomatic bone exposed intraorally through sulcular incision
4 hole titanium bone plate was used to fix the fractured segments
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Successful fixation of fractured facial bone without any scars

20/12/2014

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An 18 year old boy came to our hospital with the complaint of fractured facial bone on the right side due to road traffic accident.  He had difficulty in opening his mouth wide and was complaining of facial asymmetry due to backward displacement of fractured facial bone. 

After thorough clinical and radiological examination, Maxillofacial Surgeon  Dr. S.M.Balaji diagnosed fractured right body of zygoma with posterior displacement. This led to difficulty in mouth opening due to hindered movement of coronoid process. To avoid scar formation, intraorally through sulcular incision fractured zygoma was exposed, elevated and fixed using 4 hole titanium bone plate. This improved his mouth opening dramatically.  Patient was very happy to have fractured facial bone fixation without any surgical marks.
Preoperative 3DCT scan showing right body of zygoma fracture involving orbital floor and alveolar process of maxilla
Fractured zygomatic bone exposed intraorally through sulcular incision
4 hole titanium bone plate was used to fix the fractured segments
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Successful infected bone plates removal without any scars

3/10/2014

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A 27 year old man from Andaman reported to our hospital with the complaints of pain in right side of his face particularly lateral to his right eye and cheek region. He gave the history of road traffic accident 2 years back and had operated elsewhere. On thorough clinical and radiological examination he had stainless steel bone plates in lateral orbital rim and anterior maxillary process on his right side to traumatic facial bone fractures.

Those plates were infected which developed pain. Maxillofacial Surgeon Dr. S. M. Balaji successfully planned to remove his infected bone plates without any scars on his face. Lateral orbital rim plate was exposed and removed using lid crease incision and in maxillary process “L” plate was removed intraorally. Thus patient was very happy to have his infected plates removed without any scars on his face. 

Preoperative 3DCT view of the skull showing bone plates fixed in lateral orbital rim and anterior maxillary process on right side
Lid crease incision made on the right eyelid to avoid visibility of scars
Bone plate was exposed via the lid crease incision
Surgically removed bone plates with screws from the lateral orbital rim and anterior maxillary process
Immediate postoperative view after suture removal following seven days of the surgery
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Simultaneous corrective jaw surgery and cosmetic nose correction without any scars

19/9/2014

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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
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Enhanced aesthetics with successful scar revision

17/9/2014

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A 36-year-old man was previously surgically treated for fracture of the lower jaw that he sustained in a road traffic accident. Following successful treatment, he reported to our hospital seeking a correction of the unsightly scar on his lower lip to enhance his appearance.

Maxillofacial Surgeon Dr. S.M. Balaji performed the scar revision surgery. Following suture removal, the lower lip appeared reshaped with a more natural form. The scar was negligible and the man was very happy that his facial appearance was greatly improved. 
Preoperative view showing huge scar with significant discontinuity in the shape of the lower lip due to trauma
Immediately following the surgical correction of lip defect achieving the continuity of the shape of the lower lip
2 weeks postoperative view showing complete removal of scar with corrected lip defect
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Primary cleft lip repair for a Maldivian baby girl

11/6/2014

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A 2-month old baby girl from Maldives born with unilateral cleft lip and palate was brought to our hospital by her parents for cleft treatment.

Maxillofacial Surgeon Dr. S.M. Balaji skillfully performed the primary cleft lip repair using modified Millard’s technique. Following surgery, the baby’s appearance & feeding improved greatly. The baby’s parents were very happy that the surgery caused no scars on the face. They have gone back to their homeland and will return subsequently for cleft palate surgery.
Baby girl with unilateral cleft lip and palate
Primary cleft lip repair with modified Millard's technique
Appearance improved immediately after primary cleft lip repair
Following primary cleft lip repair scarless look 10 days postoperative
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