After thorough clinical, radiological and histopathological examination, Maxillofacial Surgeon Dr. S. M. Balaji diagnosed it as ameloblastoma involving the entire anterior segment of mandible. Surgery was planned to remove the lesion and reconstruct the affected jaw portion using costochondral rib graft in a single stage. Intraorally, complete removal of the lesion along with the involved teeth with sufficient clearance of the bone was given. Costochondral rib graft was fixed to reconstruct the mandibular defect. Incision was closed in layers. Patient feels very happy to have both removal and reconstruction in a single surgery.
A 32 year old woman reported to our hospital with the complaint of swelling with pain in the front region of lower jaw. She added that the pain was only for last 3 months and the swelling was gradually increasing to the present size for a period of 6 months. After thorough clinical, radiological and histopathological examination, Maxillofacial Surgeon Dr. S. M. Balaji diagnosed it as ameloblastoma involving the entire anterior segment of mandible. Surgery was planned to remove the lesion and reconstruct the affected jaw portion using costochondral rib graft in a single stage. Intraorally, complete removal of the lesion along with the involved teeth with sufficient clearance of the bone was given. Costochondral rib graft was fixed to reconstruct the mandibular defect. Incision was closed in layers. Patient feels very happy to have both removal and reconstruction in a single surgery.
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A 3-month-old baby boy born with unilateral cleft lip & palate defect was brought to our hospital by his parents for the surgical correction of his lip defect.
Maxillofacial Surgeon Dr. S. M. Balaji performed the primary cleft lip repair surgery using the Modified Millard’s technique. The baby’s parents were very happy that their baby’s lip defect was corrected with hardly any scars and the child’s appearance greatly improved. The baby and his family went back to his hometown and they are to return later for further cleft management. A 35 year old man came to our hospital for expert treatment for his lower jawbone defect. He had surgical removal of squamous cell carcinoma involving right side buccal mucosa and removal of affected portion of mandible and reconstruction of the soft tissue was done using PMMF (Pectoralis Major Myocutaneous Flap) elsewhere. Had postoperative radiotherapy for following 3 months which lead to severe mouth opening restriction. He also complained of jaw deviation towards left side and facial asymmetry. He was seeking to improve the quality of life by reconstructing the affected side of the face. Maxillofacial Surgeon Dr. S.M. Balaji performed the clinical and radiological investigations. OPG and 3D CT scan showed complete absence of left side body, angle and ramus of mandible including condylar component. Dr. Balaji successfully reconstructed the huge mandibular defect through the previous scar maintaining the contour of mandible using titanium “L” plate and costochondral rib graft and thus missing condylar component was also reconstructed, the surgical site was closed in layers. Patient feels very happy to have complete facial asymmetry correction in a single surgery. Following good bone formation dental implants will be fixed to enhance his chewing ability. A 20-year-old boy came to our hospital seeking to treat the huge discolored swelling in the tongue. He complained of a growth of tissue protruding from the tongue which was initially small and gradually grew to the present size and the overlying skin was fiery red & blistered. This was adversely affecting the speech and swallowing pattern. He wanted a permanent treatment.
Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the surgical treatment. An angiogram revealed the lesion to be a hemangioma. Dr. Balaji performed a glossectomy along with the hemagioma lesion removal along the borders without affecting the shape of the tongue and taste perception. The patient recovered well and is happy to have an improved appearance and the defect cured. A 28 year old woman reported to our hospital with the complaint of swelling in the right side of her face. She added that there was pain in her lower jaw before later reduced and she had intraoral swelling. After thorough clinical and radiological examination, Maxillofacial Surgeon Dr. S. M. Balaji diagnosed it as ameloblastoma involving the right side body of the mandible. Surgery was planned to remove the lesion and reconstruct the affected jaw portion in a single stage. Through submandibular incision, complete removal of the lesion along with the involved tooth with sufficient clearance of the bone under General anesthesia. Costochondral graft which was harvested was fixed to it. Incision was closed in layers. Patient was happy to have both removal and reconstruction in a single surgery. Video showing mental nerve separated and saved A young man came to our hospital wanting to correct the shape of his broad, bulky nose that gave his face an unattractive appearance. Maxillofacial Surgeon Dr. S.M. Balaji performed a reduction rhinoplasty. The large bulky nose was reduced by removing excessively curved lower lateral nasal septal cartilages bilaterally and medial osteotomy done to reduce the height of the nose. Thus nose was made more proportionate and sharp with reduction rhinoplasty. Entire surgery was approached through the nose avoiding scar formation. The man was very happy that his appearance improved greatly and his nose defect was corrected without any visible surgical marks on the face. 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 28 year-old man came to our hospital with a complaint of pain in his lower jaw. A digital X-ray and 3DCT scan was taken revealed a large cystic lesion extending from canine to canine of the mandible with complete erosion of the labial plate. Maxillofacial surgeon Dr. S.M. Balaji expertly removed the entire cystic lesion along with the lining with affected teeth in toto. Reconstruction of the bone defect was done using bone graft obtained from the retromolar region. Following surgery the wound healed well and the patient was happy to be cured of his ailment. This is a case of ameloblastoma involving right side of mandible. Resection and reconstruction of the huge mandibular defect was done without any bone grafting using distraction osteogenesis. Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected using univector intraoral mandibular distraction technique. Simultaneous resection of huge tumor and reconstruction using native bone was done using distraction osteogenesis. By sequential activation of the distractor device, the native bone was made to grow and fill the entire bone defect. Patient feels happy to have both removal and reconstruction of the entire jaw bone defect without any bone graft. A 28 year old woman reported to our hospital with the complaint of swelling in the right side of her face. She added that there was pain in her lower jaw before later reduced and she had intraoral swelling. After thorough clinical and radiological examination, Maxillofacial Surgeon Dr. S. M. Balaji diagnosed it as ameloblastoma involving the right side body of the mandible. Surgery was planned to remove the lesion and reconstruct the affected jaw portion in a single stage. Through submandibular incision, complete removal of the lesion along with the involved tooth with sufficient clearance of the bone under General anesthesia. Costochondral graft which was harvested was fixed to it. Incision was closed in layers. Patient was happy to have both removal and reconstruction in a single surgery. VIDEO: Video showing inferior mandibular nerve separated and saved A 23 year old woman reported to our hospital seeking to correct her deviated nose which greatly affected her facial appearance. She was very much disappointed as her nose was completely deviated to the right side giving asymmetric facial appearance. Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the cosmetic rhinoplasty. Costochondral rib graft obtained to augment the dorsum of the nose. Vertically nasal septal cartilage height was trimmed by medial osteotomy to reduce the height of the nose. Deviated nasal bone was corrected by lateral osteotomy technique. Thus deviated nose and size of the framework of the nose was corrected from inside the nose to avoid any scars on the face (closed rhinoplasty technique). A balance between the nose shape and facial profile was achieved for a more pleasing appearance. The patient was very happy to have a narrower, shapely nose that enhanced her facial profile with absolutely no scarring. A 24 year old girl from Dubai, a known case of unilateral cleft lip and palate reported to our hospital seeking for lip correction. Primary cleft lip repair was done elsewhere resulting in thinning of upper lip. Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected this defect using bullhorn lip lift technique.
There are different types of lip lift surgery. The most commonly used lip lifting technique is known as the ‘bullhorn lip lift’. Pre-operative markings on the skin ensure the lip lift is approximately symmetric. Advancement of the inferior edge of skin directly beneath the nasal base lifts the lip, producing more visible vermilion and about 3 mm of teeth show at rest. The position of the final incision is such that it is located within the shadow of the nose. Meticulous technique produces an almost invisible scar. The amount and width of skin excised is individualized depending on the desired aesthetic goals. Lip lifts using this technique provide an immediate, dramatic, and permanent result. 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. Complete removal of huge infected cyst involving entire anterior maxilla followed by reconstruction26/6/2016 A 26 year-old boy form West Bengal came to our hospital with a complaint of swelling with occasional pain in his upper jaw. A digital X-ray took revealed a large cystic lesion extending anterior teeth to premolar of the maxilla with complete erosion of the labial plate. Histopathological examination of the specimen showed it to be a huge infected dental cyst due to continuous trauma from occlusion resulting from anterior deep bite. Maxillofacial surgeon Dr. S. M. Balaji successfully removed the entire cystic lesion along with the lining in toto. Followed by defective region of the upper jaw was reconstructed using costochondral rib graft. Following surgery the wound healed well and the patient was happy to be cured of his ailment. After complete bone formation, fixed dental replacement of the missing teeth will be done using dental implants. Surgical correction of telecanthus due to naso-orbito-ethmoidal fracture without any scars25/6/2016 A 16 year old boy from Nepal reported to our hospital with the complaint of cosmetic defect near the left eye, continuous tearing of eyes. His history revealed that he had sustained a blunt injury in the upper half of the face due to road traffic accident and he was primarily treated elsewhere 6 months back. On clinical examination there was increased canthal distance in the left side from midline and obliteration of the canthal bay and caruncle. Lacrimal punctum did not dip into the lacrimal lake, thereby causing epiphora. 3DCT revealed an old medial wall fracture with minimal difference in skeletal intra orbital distance at the posterior poles of the globes. Hence the unilateral telecanthus was entirely soft tissue in origin and in this case, due to the faulty reattachment of the medial canthal ligament. Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected this defect using modified miniplate technique for the reattachment of the medial canthal ligament. Results were immediate and patient feels very happy to have the entire correction of eye defect along with epiphora correction without any visible scars on the face. A 12 year old girl was brought to our hospital with a complaint of facial deformity. No history of trauma elicited by her parents. Extra oral examination revealed retruded mandible, deviation of chin towards left side. 3DCT revealed obliterated left joint space elongated coronoid process, reduced ramal height and prominent antegonial notch. The case was diagnosed as hypoplastic ramus on left side with developing secondary facial deformity. Maxillofacial Surgeon Dr. S. M. Balaji successfully performed left condylar component reconstruction using 7th costochondral rib graft (CCG). Postoperative mouth opening was adequate. Over 6 years follow up; CCG was favorable where it acts as a growth centre to induce bone growth and thus facial asymmetry was corrected without any visible scars on her face. A 16 year old boy born with bilateral cleft lip and palate came to our hospital for expert cleft treatment. He was operated elsewhere for primary cleft lip and palate. He had a thin upper lip and broad flattened nose for which he sought treatment. Maxillofacial Surgeon Dr. S.M. Balaji performed the specialized Abbe flap technique to correct the upper lip. A flap of tissue was taken from the lower lip and used to reconstruct the upper lip with the base of the flap still attached to the lower lip. Once blood supply was established, the flap will be divided giving the upper lip a more natural, improved form. Simultaneously, the broad nose was reshaped to make them more proportionate and balanced. Following surgery, the nose appeared sharp & defined with more proportionate profile. A 16 year old girl reported to our hospital with the complaint of inability to open her right eyelid completely. On examination, history of blepharoptosis of right eye since birth was seen with no other functional or ophthalmic complications. Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected this defect without any visible scar on her face. Resection and advancement of levator aponeurosis was the technique used in correction of blepharoptosis. Patient feels very happy to have corrected eye lid function without any scar on the face. A 3 month old baby girl was born with unilateral incomplete cleft lip. Her parents brought to our hospital for surgical management.
Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the cleft lip repair using modified Millard’s technique. Following suture removal 7 days after surgery, the baby’s appearance was greatly enhanced. The baby’s parents were very happy to have the cleft lip defect corrected with very negligible scar. A 24-year old female from Mumbai born with a deformed right ear, sought the expertise of Maxillofacial Surgeon Dr. S.M. Balaji for reconstruction of her ear defect. Previously, in some other hospital elsewhere, multiple attempts to reconstruct the ear were done but she was not satisfied with the results. Hearing was normal. Dr. Balaji employed the Limberg’s flap to successfully reconstruct the ear lobule. Followed which stage wise complete ear lobe reconstruction done using costochondral rib graft. Costal cartilage was harvested; external framework was carved and tunneled to reconstruct the external ear. After suction, the skin was seen getting adhered to the cartilage. This was followed by the second-stage surgery to elevate the newly formed ear from the side of the head using split skin graft obtained from right thigh region. Thus, entire shape and size of the ear was reconstructed with enhanced appearance without much visible scars. A 6-month-old baby girl born with unilateral cleft lip and palate was brought to our hospital by her parents for specialized treatment of the cleft defect.
Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the primary cleft lip repair using modified Millard’s technique. Right away after surgery the baby’s appearance was remarkable improved and she was able to feed well. Her parents were very happy to have the cleft lip treated with negligible scar formation. After few months cleft palate repair will be done. A 25-year-old woman reported to our hospital with a complaint of swelling with pain in her left side of lower jaw. A digital X-ray took revealed a large cystic lesion extending entire ramus and angle and part of the body of the mandible involving the molar teeth. Histopathological examination of the specimen showed it to be a chronic infected dentigerous cyst. Maxillofacial surgeon Dr. S.M. Balaji expertly removed the entire cystic lesion along with the lining with affected teeth in toto. Following surgery the wound healed well and fixed molar teeth given using dental implants in the newly formed bone with good retention, patient was happy to be cured of her ailment and to have fixed teeth. A 19-year-old boy came to our hospital seeking to correct his facial asymmetry that gave unpleasant appearance. The boy was very anxious & wanted a cosmetic correction to enhance his appearance without any scars.
Maxillofacial Surgeon Dr. S.M. Balaji diagnosed that the asymmetrical face was due to unilateral masseter hypertrophy. Masseter muscle is mainly responsible for the movements of the lower jaw & plays an important role in facial aesthetics. When the muscle becomes enlarged or thickened, it gives the lower third of the face a wide, square-shaped appearance. Maxillofacial Surgeon Dr. S. M. Balaji surgically reduced the bulk of the enlarged Masseter muscle from within the mouth itself so there were no scars. Along with the muscle, the buccal surface of the gonial angle of the mandible was also trimmed. Immediately after surgery the lower jaw appeared more proportionate and his appearance greatly improved. The boy and his family were very happy to have a more attractive, natural look. A young man reported to our hospital seeking the expertise of Maxillofacial Surgeon Dr. S.M. Balaji for the cosmetic correction for his nose defect. He had met with an accident and he had a defect in the left nostril (loss of tissue). It was decided to do a nose reconstruction using forehead flap. The advantages of a forehead flap is that the skin color closely matches that of the nose and the harvest site is very close to the surgery site.
Alar base reconstruction was done using forehead flap. Step one was done where the forehead pedicle flap was rotated and attached to the existing ala maintaining good blood supply and following 21 days, second step of flap division was done where exact shape and size of left ala was created without any visible scar and skin discoloration. 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. |
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