Lower Lip Reduction Surgery – Best Result for thick lips
[et_pb_section fb_built=”1″ _builder_version=”3.22″][et_pb_row _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text _builder_version=”3.27.4″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”] Importance of lip size on facial esthetics – Lip Reduction Surgery Lip size is very important for correct facial esthetics. Surgical correction of lip size comes under cosmetic surgery. Lips that are too big or too small for the face need corrective surgery. The relationship between the sizes of each lip is also important or lip reduction surgery correct the difference in size of the lips. Lips exercise undue influence over how we look. Upper and lower lip size should match. The lips should blend into the patient’s skin tone. This will enhance the patient’s facial features. Lips smaller than normal give a pinched look to the face. Patients with large lips, bigger than normal, desire a lip reduction procedure. Cost of lip surgery in India Lips surgery cost in India is much lesser than it is in the developed western countries. How to reduce lip size has to be decided on before surgery. Oral and Maxillofacial surgeons and plastic surgeons perform this procedure in India. The former also perform cosmetic plastic surgery on the face. Minor corrections can also be done under local anesthesia. Patients with complicating medical conditions need to undergo a thorough checkup before surgery. This will prevent any undue side effects from medications used for surgery. Patient with disproportionate upper lip presents at our hospital This patient is from Kurnool, Telangana. He was born with a large lower lip, which was also everted. This affected his speech to an extent. He felt that it was also difficult to keep the lips apposed. His search for the best lip reconstruction surgeon in India brought him to us. He thus presented to our hospital for lower lip reduction surgery. He desired surgery for reducing lip size. Initial Examination and biometric analysis for treatment planning Dr SM Balaji, a premier cosmetic lip surgery specialist in India, examined the patient. He used biometric analyses to study the patient’s lips and face. His treatment plan for the patient was cheiloplasty. He then explained the exact extent to which the lower lip needed reduction. The surgical procedure was then explained in detail to the patient who gave consent. Reducing the size of the lip was then planned. This is a common surgery performed by both plastic and maxillofacial surgeons. Surgical reduction with removal of excess tissue from the upper lip General anesthesia was first induced. The region of the lower lip that needed reduction was then identified. Markings were then made on the lip. An incision was then made along the markings made on the lip. Dissection was then carried down into the submucosal region. Excess tissue was dissected and excised from the region. Vermillion borders of the lip incision were then closely reapproximated with sutures. The patient expressed complete satisfaction at the results of the cosmetic lip surgery. Surgery Video [/et_pb_text][et_pb_text _builder_version=”4.9.0″ _module_preset=”default”] Lower Lip Reduction Surgery [/et_pb_text][et_pb_text _builder_version=”4.9.0″ _module_preset=”default”] Importance of lip size on facial esthetics – Lip Reduction Surgery Lip size is very important for correct facial esthetics. Surgical correction of lip size comes under cosmetic surgery. Lips that are too big or too small for the face need corrective surgery. The relationship between the sizes of each lip is also important or lip reduction surgery corrects the difference in the size of the lips. Lips exercise undue influence over how we look. Upper and lower lip sizes should match. The lips should blend into the patient’s skin tone. This will enhance the patient’s facial features. Lips smaller than normal give a pinched look to the face. Patients with large lips, bigger than normal, desire a lip reduction procedure. Cost of lip surgery in India Lips surgery cost in India is much lesser than it is in the developed western countries. How to reduce lip size has to be decided on before surgery. Oral and Maxillofacial surgeons and plastic surgeons perform this procedure in India. The former also perform cosmetic plastic surgery on the face. Minor corrections can also be done under local anesthesia. Patients with complicating medical conditions need to undergo a thorough checkup before surgery. This will prevent any undue side effects from medications used for surgery. Patient with disproportionate upper lip presents at our hospital This patient is from Kurnool, Telangana. He was born with a large lower lip, which was also everted. This affected his speech to an extent. He felt that it was also difficult to keep the lips apposed. His search for the best lip reconstruction surgeon in India brought him to us. He thus presented to our hospital for lower lip reduction surgery. He desired surgery for reducing lip size. Initial Examination and biometric analysis for treatment planning Dr SM Balaji, a premier cosmetic lip surgery specialist in India, examined the patient. He used biometric analyses to study the patient’s lips and face. His treatment plan for the patient was cheiloplasty. He then explained the exact extent to which the lower lip needed reduction. The surgical procedure was then explained in detail to the patient who gave consent. Reducing the size of the lip was then planned. This is a common surgery performed by both plastic and maxillofacial surgeons. Surgical reduction with removal of excess tissue from the upper lip General anesthesia was first induced. The region of the lower lip that needed reduction was then identified. Markings were then made on the lip. An incision was then made along the markings made on the lip. Dissection was then carried down into the submucosal region. Excess tissue was dissected and excised from the region. Vermillion borders of the lip incision were then closely reapproximated with sutures. The patient expressed complete satisfaction with the results of the cosmetic lip surgery. Surgery Video [/et_pb_text][et_pb_video src=”https://youtu.be/XbgaH5rmnck” _builder_version=”4.9.0″ _module_preset=”default”][/et_pb_video][/et_pb_column][/et_pb_row][/et_pb_section]
Dr SM Balaji had an impactful presence at the 94th IADR General Session and Exhibition held in London 2018
[vc_section content_layout=”full” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=””][vc_custom_heading text=”International Association for Dental Research (IADR)” use_theme_fonts=”yes”][/vc_column][/vc_row][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/2″][vc_column_text]Dr SM Balaji attended the 94th General Session of the International Association for Dental Research (IADR). The IADR exhibition was also held at the same time. These events were both held at the London Convention Center, London in July 2018. He is the Secretary General of the Indian Division of the IADR. The session was a grand success with many meetings held. Plans were made for implementing the cause of dental research throughout the world.[/vc_column_text][/vc_column][vc_column layout=”normal” vertical_align=”top” animation_delay=”” width=”1/2″][vc_single_image image=”4939″ img_size=”full” add_caption=”yes”][/vc_column][/vc_row][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=””][vc_column_text] The importance of the IADR in Global Dental Research IADR is the premier world body responsible for streamlining dental research. It is responsible towards laying down guidelines for dental research. Important areas of research are first identified by the IADR. It is then prioritized taking into account the current need for the research. Research grants are then distributed taking into account all factors. Outstanding research contributions are also recognized and awarded by the IADR. Prestigious IADR awards in all categories are also given at annual general sessions. The IADR governing body consists of service minded individuals who guide research worldwide. Journal of Dental Research (JDR), the official journal of the IADR, is one of high prestige. Research works of great value feature in each edition of the journal. Role played by Prof SM Balaji in furthering IADR activities The board meeting of the International Association for Dental Research-Asia Pacific region (IADR-APR) was also held. Prof SM Balaji, Past President of the IADR-APR played an integral role in it. This was helmed by Prof Rena D’Souza, President, IADR. Also present at the meeting were Dr Christopher Fox, Executive Director, IADR and Prof Chuanbin Guo, President, IADR-APR amongst others. Many important issues were discussed at the session. Decisions towards the improvement of dental research in the region were also formulated. Planning for laying down the structures needed for successful implementation was also done here. Of note, special mention was made by Prof D’ Souza about the stellar role Dr SM Balaji played as Secretary General of the Indian Society For Dental Research (ISDR) in organizing the symposium on dental research at Saveetha Dental College, Chennai and the 30th Annual Conference of the Indian Society of Dental Research at the Center for Dental Education and Research (CDER) in AIIMS, New Delhi in 2018. She noted that both the events were a grand success with the participation of over 1000 delegates.[/vc_column_text][vu_gallery type=”standard” layout=”2″ style=”with-space” space=”” class=””][vu_gallery_item image=”4943″ ratio=”4:3″ size=”1×1″ title=”Dr Rena D’ Souza at the IADR APR board meeting” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][vu_gallery_item image=”4944″ ratio=”4:3″ size=”1×1″ title=”Dr Christopher Fox at the IADR APR board meeting” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][vu_gallery_item image=”4945″ ratio=”4:3″ size=”1×1″ title=”Dr Chuanbin Guo at the IADR APR board meeting” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][vu_gallery_item image=”4946″ ratio=”4:3″ size=”1×1″ title=”Dr Kazuhisa Yamazaki at the IADR APR board meeting” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][/vu_gallery][/vc_column][/vc_row][vc_row content_layout=”boxed” equal_height=”” animation_delay=”” disable=”” id=”” class=”” bg_type=”image” bg_image=”” color_overlay=”” enable_parallax=”” enable_pattern=””][vc_column layout=”normal” vertical_align=”top” animation_delay=””][vc_column_text] Council meeting and council dinner hosted by Dr Angus Walls Prof SM Balaji also participated in the council meeting of the IADR. This saw active participation by all the international council members of the IADR. Following this was the IADR Council dinner hosted by Colgate, UK at the Tower Bridge, London. Dr Angus WH Walls, Past President, IADR, made the inaugural speech. He welcomed the distinguished members of the IADR to the dinner. Dr Kathryn Kell, President, FDI World Dental Federation attended the dinner. Also present was Dr Enzo Bondioni, Executive Director, FDI World Dental Federation.[/vc_column_text][vu_gallery type=”standard” layout=”3″ style=”with-space” space=”” class=””][vu_gallery_item image=”4950″ ratio=”4:3″ size=”1×1″ title=”Dr SM Balaji at the IADR Council meeting” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][vu_gallery_item image=”4951″ ratio=”4:3″ size=”1×1″ title=”Dr SM Balaji seated with delegates at the IADR Council meeting” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][vu_gallery_item image=”4952″ ratio=”4:3″ size=”1×1″ title=”Dr SM Balaji participates in the IADR Council meeting” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][vu_gallery_item image=”4953″ ratio=”4:3″ size=”1×1″ title=”Dr Angus Walls welcomes everyone at the Council dinner” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][vu_gallery_item image=”4954″ ratio=”4:3″ size=”1×1″ title=”Dr Kathryn Kell and Dr Enzo Bondioni of the FDI at the council dinner” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][vu_gallery_item image=”4955″ ratio=”4:3″ size=”1×1″ title=”Dr Angus Walls shares a lighter moment with other delegates” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][vu_gallery_item image=”4956″ ratio=”4:3″ size=”1×1″ title=”Dr SM Balaji with Dr Rena D’ Souza, President IADR” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][/vu_gallery][vc_row_inner equal_height=”” animation_delay=”” disable=”” id=”” class=””][vc_column_inner vertical_align=”top” animation_delay=””][vc_column_text] Science information committee meeting of the IADR The IADR Science Information Committee (SIC) meeting was also conducted at the London Convention Center as part of the 94th IADR General Session and Exhibition. Dr Peter Mossey and Dr SM Balaji participated actively in the SIC meeting.[/vc_column_text][/vc_column_inner][/vc_row_inner][vu_gallery type=”standard” layout=”2″ style=”with-space” space=”” class=””][vu_gallery_item image=”4958″ ratio=”4:3″ size=”1×1″ title=”Dr Manu Mathur, Dr Peter Mossey and Dr Alexander Vieira at the Science Information Committee meeting” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][vu_gallery_item image=”4959″ ratio=”4:3″ size=”1×1″ title=”Dr SM Balaji at the Science Information Committee meeting” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][vu_gallery_item image=”4960″ ratio=”4:3″ size=”1×1″ title=”Dr Christopher Fox at the Science Information Committee meeting” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][vu_gallery_item image=”4961″ ratio=”4:3″ size=”1×1″ title=”The Science Information Committee meeting in progress” subtitle=”” category=”” link_type=”lightbox” show_icon=”” class=””][/vu_gallery][vc_column_text] General session and exhibition opening ceremony in London Prof SM Balaji took part in the official opening ceremony of the 94th IADR General Session and Exhibition. The opening speech by Prof Rena D’Souza, President, IADR, was very thought provoking. It touched upon the pressing need for further research into all aspects of oral health. She thanked everyone who had been of immense help in assisting her in her research activities over the years. Prof SM Balaji met with Professor Mike Curtis, Executive Dean of Dentistry, Kings College of London, Guy’s Hospital. He also met
RTA, Coronoid Zygoma Malunion, Trismus Corrective Surgery
Patient with inability to open mouth following depressed zygoma fracture The patient is a middle-aged man from Hassan, Karnataka. He suffered a comminuted zygoma fracture from a road accident. Improper reduction elsewhere had left him with a depressed zygoma and trismus. The depressed zygoma led to facial asymmetry and impingement of the coronoid process. This resulted in a mouth opening of only 1 cm for the patient. The patient had complaints of inability to eat well as well as impaired speech. He was becoming withdrawn and avoiding social interaction. This became a hindrance to normal functioning in day to day life. His friends searched for the best hospital to get his asymmetry corrected. They took him to a local oral surgeon who studied the case in depth. Findings were somewhat complicated and needed an experienced surgeon. He was then referred to our hospital for correction of his complaints. Various aspects of correction of facial asymmetry No human face has perfect symmetry. Perfect symmetry is impossible in biological organisms. There is always a small degree of asymmetry present in all structures. The human face is no exception to this law of nature. This facial asymmetry is imperceptible in 99.90% of the population. It is only in a small minority that there is noticeable asymmetry. This asymmetry could be congenital or acquired. Congenital facial asymmetry could be the result of birth defects or injuries. Improper use of forceps during delivery can result in facial asymmetry. Cleft lip and palate deformities result in severe facial deformities. Correction of this requires the services of an experienced cleft surgeon. The majority of acquired facial asymmetry is through trauma. An asymmetrical face can lead to psychological problems. The patient becomes very self conscious and withdraws from social interactions. Types of presentation of asymmetry of the face Facial asymmetry can involve the soft tissues alone or can involve the hard tissues also. Treatment options depend upon the location and degree of asymmetry. The main aim of treatment is to restore facial symmetry. We are one of the premier hospitals for facial asymmetry correction in India. Correction of the asymmetry of his face will undergo correction here. Jaw surgery is among the most common asymmetry correction surgeries performed in India. Orthognathic surgery can also correct facial asymmetry. Both maxillofacial as well as craniofacial surgeons perform these surgeries. Treatment planning explained to the patient in detail for correction of problems Dr SM Balaji, a premier facial deformity correction surgeon in India, examined the patient. He specializes in all manifestations of facial asymmetry. A world renowned cleft surgeon, all types of facial asymmetry undergo correction here. Facial asymmetry due to paralysis is also corrected at our hospital. Patients undergoing rehabilitation are able to lead a completely normal life after surgery. Their ability to smile restored, they are able to face life with dignity and self confidence. Clinical examination revealed impingement of the left coronoid process during mouth opening. The patient had a mouth opening of only 1 cm. There was a depressed left zygoma with resultant facial asymmetry. He explained the treatment planning to the patient, which included a left coronoidectomy. This would enable good mouth opening again for the patient. The patient was in agreement and consented to the facial deformity correction surgery. Left coronoidectomy performed on the patient to enable mouth opening The patient underwent fiberoptic bronchoscopic intubation for general anesthesia. This was due to his inability to open his mouth for oral intubation. A tracheostomy would have to be performed otherwise. Once under satisfactory general anesthesia, a left retromolar incision was first made. The coronoid process was then accessed. A coronoidectomy was next performed and the coronoid process removed. The patient’s mouth opening was then demonstrated to be about 5 cm. This falls within the parameters of normal mouth opening. The incision was then closed with sutures. Depressed zygoma elevated and fixed with plates for facial asymmetry correction The depressed zygoma was next addressed. It was impinging on the coronoid process during mouth opening. This was preventing full opening of the mouth. Zygomatic bone was then approached through two approaches. They were through the maxillary vestibular incision and lateral canthal incision. The zygoma was first refractured to set right the depression. It was then fixed in an elevated position with the use of plates. Both incisions were then closed with sutures. The patient expressed his total satisfaction at the results of the surgery. Surgery Video
Fracture of the lower jaw open reduction and fixation surgery
Open bite from displacement of reduced fracture This young man is from Chennai, Tamil Nadu. He had a bike accident a week ago. Direct impact to his mandible resulted in a fracture of the mandible. He sustained facial injury as a result of this accident. This resulted in inability to close his mouth with an open bite. There were no soft tissues injuries from this accident. The patient never lost consciousness. He remained lucid during the immediate period after the fracture. Examination by a neurologist revealed no signs of head injury in the patient. The neurologist explained to the family that the helmet had saved the patient’s life. He explained through charts how the injuries would have been very severe if the patient had not been wearing his helmet. Presentation at our hospital for management of fracture His family wanted the best treatment for his jaw fracture. They made enquiries about the best jaw fracture surgeon in India. He was then brought to our Balaji Dental and Craniofacial Hospital for treatment. Our hospital is a premier hospital for jaw fracture surgery in India. Success rate of surgery for mandibular fractures at our center is amongst the best in India. Our hospital is a specialty maxillofacial surgery center. We deal with cases of maxillofacial trauma on a daily basis. Our center is a top referral center among city plastic surgeons. Special training through workshops are a regular feature at our hospital. Many oral and maxillofacial surgeons undergo this training. Fractures of the bones of the face are a common feature at these workshops. Injuries to the face are a common occurrence in the city. Treating these injuries needs the utmost care. Treatment plan presented and consent obtained from patient Dr SM Balaji, facial trauma surgeon in India, examined the patient. He obtained imaging studies for the patient. There was no fracture involvement of the eye sockets. There was no involvement of other facial bones or soft tissue. Any dental implants along the fracture line would need removal if present. Fracture was only at the left mandible. This came under the classification of facial fractures. There had been no facial lacerations from the accident. Location of the fracture determined his treatment plan. Rigid fixation was essential for fracture stability. Fracture treatment would be through open reduction and internal fixation. This decision was based upon his experience with jaw fractures correction. The patient consented to the treatment plan. All appropriate consents were next signed by the patient and surgery scheduled. Open reduction versus closed reduction Open reduction and closed reduction are two ways of setting a fractured bone. The fractured segments of the bone stay reduced when it is a favorable fracture. The anatomy of the fracture ensures this. Certain fractures can be reduced without any skin incisions. These stay in place without displacement with plaster casts alone. This is a closed reduction. The break has to be clean without comminution of the fracture. Fractures that do not stay reduced need open reduction and internal fixation. An incision is first made to gain access to the fracture site. Titanium plates and screws are then used to fix the fragments of bone to each other. This results in stabilization of the fracture. Incisions used to access the fracture are then closed with sutures. This is then followed by a period of immobilization for consolidation of bone. A closed reduction is possible only in a favorable fracture. All other fractures need open reduction and internal fixation. Fractures of the mandible can be favorable or unfavorable fractures. Favorable mandibular fractures stay stabilized with closed reduction and intermaxillary wiring. Care should be taken to maintain proper occlusion of the teeth. These fractures heal without any further intervention. Unfavorable mandibular fractures can comprise of several fracture segments. These do not stay stabilized with closed reduction. They need correction through stabilization with titanium plates and screws. An incision is first made to access the fracture site. The fracture fragments are then brought together into proper anatomical alignment. Titanium plates and screws are then used to stabilize the fracture. Occlusal harmony of the teeth should be ensured before final closure. The patient needs to return for periodic checks for a prescribed period of time. Full bone consolidation at the fracture site ensures complete healing of the fracture. The number of plates used for fracture reduction would increase with fracture severity. Successful open reduction and internal fixation of the fracture Under general anesthesia, a left vestibular incision in the mandible exposed the fracture. The fracture segments were then brought into correct alignment and occlusion checked. The fracture was then stabilized with plates and screws. Incisions were then repaired by suturing. The patient expressed his satisfaction at the results of the surgery before discharge. He was able bring his teeth together. The open bite had undergone complete resolution. Facial esthetics was also perfect and there was no residual asymmetry. Surgery Video
Recurrent odontogenic keratocyst total enucleation and reconstruction surgery
Patient treated elsewhere for bilateral OKC four years ago with enucleation and resection This patient is from Hyderabad, Telangana. He had undergone surgery elsewhere four years for bilateral mandibular odontogenic keratocysts. These cysts form in the bones of the jaws. This type of cyst has to be surgically removed. They are not like sebaceous cysts, which are minimally invasive. These cysts are comparable to polycystic ovaries in nature. Polycystic ovary syndrome converts the ovaries into fluid filled sacs. Ovarian cysts are always removed with care taken to preserve all surrounding internal organs. The patient carries the diagnosis of Gorlin-Goltz syndrome. Occurrence of many odontogenic keratocysts is a feature of this syndrome. This is very uncommon and is an autosomal dominant inherited disorder. The patient underwent bilateral enucleation and reconstruction of his mandible. Oral and maxillofacial surgeons remove these cysts. Patient returns with pain in the left side of his mandible Four years later, the patient noticed a swelling with pain in his left lower jaw. The patient was then referred to our hospital for treatment of his condition. Dr SM Balaji, an expert in mandibular reconstruction in India, examined the patient. Balaji Dental and Craniofacial Hospital is a premier center for mandibular cyst removal surgery in India. He ordered diagnostic studies including a 3D CT scan. This revealed recurrence of the odontogenic keratocyst on the left side. He explained that total enucleation was the best way for removing the cyst. The patient consented to surgery after a detailed review of this. Enucleation of OKC followed by reconstruction with rib grafts The surgical procedure commenced after general anesthesia. Rib grafts were first obtained through the old inframammary scar. A Valsalva maneuver confirmed patency of the thoracic cavity. The incision was then closed with sutures. Following this, a left sided vestibular incision was next made. The OKC was then thoroughly enucleated from the mandible. The cyst wall lining was carefully removed completely from the lingual surface of the mandible. Care was taken to ensure there were no remnants of cyst wall lining left behind. The mandible was then reconstructed using the rib grafts, titanium plates and screws. The incision was then closed with sutures. The patient recovered well from general anesthesia. The patient will need periodic checkups over the next few years. This will be to ensure that there is no recurrence of the OKC. The patient’s facial reconstruction surgery had good results. Surgery Video
Unilateral cleft lip surgery using Modified Millard’s technique
[et_pb_section fb_built=”1″ _builder_version=”3.22″][et_pb_row _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.9.0″ _module_preset=”default” text_font_size=”16px”] Cleft Lip Surgery in India Initially, Indian Plastic Surgeon Dr. Sushruta performed cleft lip surgery in India in the 8th century B.C. He is considered the “Father of Plastic Surgery”, A Cleft lip is a birth defect: A cleft lip may only be a tiny notch in the lip. There may also be a complete split in the lip that goes all the way to the base of the nose. The cleft palate may be on one or both sides of the roof of the mouth. It may be the entire length of the palate. Your child may have either or more of these birth conditions. Procedure of Cleft Lip Surgery in India Cleft lip repair is typically performed when the infant is 3 to 6 months old. Your child will have general anesthesia for cleft lip surgery (asleep and not feeling pain). The surgeon will trim the tissues and stitch the lips together. The stitches are going to be very small so that the scar is as small as possible. Many stitches will be absorbed into the tissue when the scar heals, so they won’t have to be removed later. Procedure of Cleft palate Surgery in India Cleft palate repair is typically performed when the child is older, between 9 months and 1 year of age. This causes the palate to shift as the child grows. Doing the repair when the child is this age will help prevent further speech problems as the child develops. In cleft palate repair, your child will have general anesthesia (asleep and not feeling pain). Tissue from the roof of the mouth may be moved over to cover the soft palate. Often a child may require more than one surgery to close a palate. The surgeon may also need to repair the tip of your child’s nose during these procedures. The surgery is called rhinoplasty. Baby girl from Mathura This is a 3-month old baby girl from Mathura born with unilateral cleft lip. She also had a hole in the roof of the mouth involving the upper jaw (hard and soft palate). The patient’s mother was a known case of cleft lip and palate. There was also a familial history of clefts running through the generations. Unilateral cleft lip Cleft lip is a congenital split in the upper lip on one side often associated with cleft palate. Babies with cleft lip usually have difficulty in feeding. They may develop ear infections which may lead to hearing loss. Cleft lip surgeon in India Though aware of the condition the parents were very depressed. They felt that the lip and nose deformity might affect her future. The parents were planning to do cleft lip surgery in India. They were searching far and wide for the best cleft lip surgeon in India. A local physician referred them to our hospital. Dr. SM Balaji one of the leading cleft lip and palate surgeons in India examined the patient. He planned to perform surgical repair of the cleft lip at 3 months of age. Primary cleft lip repair Cleft lip and palate surgeon Dr. S.M. Balaji planned to perform primary lip repair at the age of 3 months. Unilateral cleft lip surgery is done using Modified Millard’s technique under general anesthesia. The cleft and plastic surgeons usually prefer this surgical procedure for children with cleft. Surgical Results: The result of the surgery was as expected. She looked like any other baby girl of her age with minimal to no scar. The parents were very pleased with the results. Cleft palate repair (cleft palate surgery) will be done at about 9 months of age. Alveolar Cleft defect reconstruction surgery with bone grafts will be planned at 3.5 years of age. [/et_pb_text][et_pb_gallery gallery_ids=”5264,5265,5266,5267,5268″ fullwidth=”on” _builder_version=”4.9.0″ _module_preset=”default”][/et_pb_gallery][/et_pb_column][/et_pb_row][/et_pb_section]
Cheekbone fracture surgery and lower eyelid correction
Patient with facial injuries This is a 35-year-old patient from Jharkhand. He was hit by a speeding car which resulted in facial trauma before 2 years. The facial trauma resulted in facial bone fractures. He underwent emergency treatment for cheekbone fracture and lower eyelid correction in Jharkhand. The patient was not happy with the outcome of cheekbone fracture surgery. He complained of depressed cheekbone in the left side of the face. He requested for further cheekbone correction. Ectropion of eye He also complained of double vision in one eye (left) and lower eyelid drooping. His lower eyelid was sagging outwards thereby exposing the surface of the inner eyelid. There was noticeable difficulty in closing his left eye. He requested left lower eyelid surgery. The patient’s eye doctor had neglected the need for a second surgery. He advised him to use eye drops every day to prevent drying up of the left eye. Cheekbone fracture surgery in India Complete clinical and radiological evaluation done. Oral and Maxillofacial surgeon Dr. SM Balaji diagnosed malunited cheekbone fracture. He had hypoglobus and ectropion of the left eye. There was also a left orbital floor fracture which led to herniation of the orbital contents. Dr. SM Balaji the leading facial reconstructive surgeon in India planned to correct all his problems in one surgery. Fracture treatment along with ectropion correction Incision placed through the previous surgical scar. Layers dissected, thereby exposing the previously placed plates and screws. Removal of plates and screws done. The malunited cheekbone fracture was re-fractured. Re-fractured segment elevated and fixed using plates and screws. The floor of orbit reached. The herniated orbital floor contents released. Left orbital floor reconstruction surgery done using Titan Medpor implant. The implant was fixed using screws. Malpositioned lower eyelid released from the scar tissue. The ectropion of the left eye was also corrected using a medial canthal incision. Surgical outcome The check bone fracture corrected. The lower eyelid raised and reattached to its normal position. The orbital floor was also reconstructed successfully. The patient was happy with the outcome of the surgery.
Hypertelorism Surgery with Frontonasal Encephalocele, Dr SM Balaji
Patient born with craniofacial deformities and cleft lip and palate This young man is from Ambala, Punjab. He had been born with marked craniofacial deformities and a cleft lip and palate. Cleft lip and palate repair performed as an infant were satisfactory. His marked nasal deformity had resulted in hypertelorism. There was also soft tissue scarring. His parents’ search for the best craniofacial surgeon for hypertelorism in India had led them to our hospital. Our hospital is well known for hypertelorism surgery in India. Orbital hypertelorism surgeries are a division of facial reconstructive surgery. We are one of the best for facial reconstructive surgery in India. These surgeries are also performed by plastic surgeons in EU nations. Treatment plan explained to the patient and his parents in detail Dr SM Balaji, Craniofacial deformity surgery specialist, examined the patient. The neurosurgical team assisted throughout this process. A 3D stereolithographic model was first obtained of the patient’s skull. A detailed study was then conducted followed by a mock box osteotomy procedure. Once the treatment plan decision had been made, this was then explained to the patient. The patient and his parents consented to surgery. The patient undergoes box osteotomy procedure for hypertelorism correction Under general anesthesia, a lumbar puncture was first performed and CSF drain placed. This was to ensure adequate control of intracranial pressure. A bicoronal flap was then raised. Following this, a craniotomy was then performed 2 cm above the supraciliary arches. The posterior cut was anterior to the coronal sutures. The squamous part of the frontal bone then removed and preserved for later placement. The frontal lobe of the brain was then exposed and around 60 mL of CSF drained. This was to decompress the brain for better surgical access. This aided in retraction of the frontal bone from the floor of the anterior cranial fossa. An osteotomy was then done parallel to the craniotomy cut to create the frontal bar. Temporalis muscle retraction aided in visualization of the inferior orbital fissure. This was then followed by bilateral osteotomies of the zygomatic arches. A transverse osteotomy was then done across the roof of the orbit. Final maxillary Le Fort I osteotomy through intraoral incisions resulted in complete disengagement of the midface. Bone was then removed from the lateral and medial regions of the orbit. Careful positioning of the bone resulted in correction of the hypertelorism. The repositioned bone segments were then stabilized with plates to the frontal bar. Intraoral incision was also closed with sutures. Treatment plan for closure of frontonasal encephalocele discovered during surgery A frontonasal encephalocele had been discovered during this stage of the surgery. There was congenital absence of duramater in this region. This could result in herniation of brain tissue at a later date. The neurosurgical team advised closure of this cavity with fat graft. Fat graft and fibrin glue utilized for closure of frontonasal encephalocele A fat graft was thus obtained from the patient for this purpose. This incision was then closed with staples. A layer of fat graft was first laid over the opening. The fat graft was next covered with fibrin glue followed by another layer of fat graft. This resulted in complete closure of the defect in the bone. The bony segments of the skull were then placed back into correct position. These segments were then fixed in position with four holed plates. The bicoronal flap was then stapled back into position. Successful completion of the first stage of the patient’s rehabilitation This completed the first stage of the patient’s surgical correction. The second stage would involve correction of the nasal deformity. The patient recovered well from surgery and was then discharged home. Surgery Video
Medial blowout fracture correction surgery for orbital volume increase plus ptosis correction by reattachment of levator palpabrae superioris
Road traffic accident leaves patient with a sunken left eye This young woman is from Tirupur, Tamil Nadu. A road traffic accident resulted in injury around the left eye. This had resulted in a blowout fracture of the left eye. Surgery elsewhere resulted in a sunken left eye and residual ptosis. This was the result of fat herniation into a medial orbital wall fracture. A local oral surgeon referred her to our hospital for surgical correction. Treatment planning explained to patient and consent obtained Dr SM Balaji, facial deformity correction specialist, examined the patient. He explained that the sunken eye was due to herniated fat. The patient also needed ptosis correction. He explained that levator palpabrae superioris muscle needed corrective surgery. The patient consented to surgery. Osteomesh utilized for correction of fat herniation into medial wall fracture After general anesthesia, the medial wall of orbit fracture was first accessed. Herniated fat was then released from the fracture site. An Osteopor-Osteomesh was then inserted to cover the fracture site. This would form a permanent film over the fracture site. Fat herniation would thus not recur at the fracture site. Fine ophthalmic sutures were then used to close the incision. Ptosis surgery done with full correction of deformity The levator palpabrae superioris was next addressed. An incision was first made at the old scar site. The muscle was then accessed and a suture used to attach it to the orbicularis oculi. This incision was also closed with fine sutures. The patient’s eye function was then tested after recovery from general anesthesia. The patient had symmetrical eyes with correction of the left eye ptosis. The patient expressed her satisfaction before discharge from the hospital.
Supraorbital rim Fracture Open Reduction Internal Fixation (ORIF) Surgery
Patient suffers a comminuted frontal bone fracture from trauma The patient suffered a trauma to the right supraorbital region. This resulted in a comminuted fracture of the supraorbital region with involvement of the rim. He presented to our hospital for definitive management of his fracture. Examination of the patient with treatment plan presentation Dr SM Balaji, facial trauma care specialist, examined the patient and ordered a 3D CT scan of the region. This demonstrated a comminuted supraorbital fracture of the frontal bone. The treatment plan was then explained to the patient who consented to surgery. Surgical correction of comminuted frontal bone fracture with four hole plates Under general anesthesia, the fracture was first approached through a supratarsal fold incision. The supraorbital rim fracture segments were then elevated and stabilized. Two Titanium four hole plates and screws were then used to fix the rim fracture. Another incision was then made superior to the left eyebrow. The supraorbital fracture segments were then elevated and stabilized. Another four hole plate was then utilized to fix the supraorbital fracture segments. Both incisions were then closed with sutures. Care was taken to protect the supraorbital nerve throughout the surgery. Successful rehabilitation of the patient after comminuted frontal bone fracture There was no residual deformity of the region after surgery. The patient expressed total satisfaction at the results of the surgery before discharge.