Lower Incisor Over Show Recorrection Genioplasty

Lower Incisor Over Show Recorrection Genioplasty

A patient opts for surgical creation of a more prominent chin

The patient is a 45-year-old male from Bhopal in Madhya Pradesh, India. Ever since he was a young man, he had always felt that he had a very small chin. He had always been dissatisfied with the shape of his chin. His desire was to have a prominent chin, which he felt would be more masculine looking.

Around a year ago, he finally decided to undergo chin enhancement surgery. He, therefore, got in touch with a facial cosmetic surgeon. Without any presurgical planning, the surgery had been performed on the very same day.

Dissatisfaction with the results of the surgery

A genioplasty had been performed with osteotomy of the chin. To his dismay, the patient realized that he could not close his lips fully. There was an unsightly excessive lower incisor overshow. He could not appose his lips.

Feeling distressed by this, he realized that his surgery needed to be redone. He began an exhaustive search for the best surgical facility to address his issue. His search repeatedly led him to our hospital.

Our hospital is a specialty surgical center for cosmetic resurgery. Many patients with botched cosmetic surgery elsewhere have undergone surgery with us with the optimal restoration of esthetics. Cosmetic lip surgery and redo rhinoplasty (revision rhinoplasty or nose job) are specialty procedures performed at our hospital.

Facelift surgery is routinely performed in our hospital. Facial plastic surgery procedures have helped many people lead fulfilling lives. Facial implants are used for correcting bony defects by plastic surgeons. Chin implant surgery is performed for enhancing retruded chins. This results in optimal chin augmentation.

Our hospital follows all the protocols laid down by the American Society of Plastic Surgeons. Head and neck surgery had rigorous guidelines that need to be followed for optimal results.

Treatment planning explained to the patient in detail

Dr SM Balaji, facial cosmetic surgery specialist, examined the patient and obtained imaging studies including a 3D CT scan. This revealed an enormous gap between the osteotomized chin and the mandible. It was explained to the patient that this gap needed to be closed as there was no new bone formation.

Care was taken to explain to him that the best course of treatment would be to reverse the previous surgery. The patient contemplated the findings presented to him and consented to surgery.

Successful reversal of his previous advancement genioplasty surgery

Under general anesthesia, a vestibular incision was made in the anterior mandibular region. The previous chin surgery with the titanium plates was exposed. There was extensive granulation tissue formation at the site of the bony gap in the chin.

The granulation tissue was carefully debrided. The titanium plates and screws holding the chin were removed and the chin was placed back into its original position. There was a good approximation of the osteotomized segment with the mandible. The incision was then closed and the patient was taken to the recovery room.

Patient happy with regaining previous facial dimensions after reversal of chin surgery

The patient’s chin had been placed back in its original position. Overshow of lower incisors was completely eliminated. He was extremely happy with the results of the surgery and thanked the surgical team before being discharged from the hospital.

Surgery Video

 


Dental Implant after Jaw Resection and Reconstruction

Dental Implant after Jaw Resection and Reconstruction

Common Jaw Pathologies that require Resection and Reconstruction

Cysts and tumors of the jaws are amongst the most common jaw pathologies. Treatment of these conditions includes jaw resection and reconstruction. The most common cysts of the jaws include dentigerous cysts and odontogenic keratocysts. Dentigerous cysts are always associated with an impacted tooth.

Importance of Jaws towards Overall Human Health

The importance of the jaws towards maintaining optimal physical and mental health cannot be understated. Proper mastication of food is very important in obtaining the nutrition that the body needs to maintain good health. Jaws also play an important role facilitating overall human health.

Effects of Jaw Pathology on Speech and Facial Esthetics

The effects of jaw pathology on speech and facial esthetics can result in a compromise in the overall quality of life. Speech therapy is often required after radical resection of jaws and jaw reconstruction surgery. Maxillofacial surgeons receive specialized training for jaw cyst surgery.

Importance of Jaw Reconstruction Surgery for Returning to Normal Life

Patients who have undergone resection of extensive jaw pathologies are often left with residual facial deformities. Patients thus affected require jaw reconstruction surgery for returning to normal life.

Cystic conditions like dentigerous cysts and odontogenic keratocysts often cause the destruction of the jawbone. Mastery over jaw reconstruction surgery takes many years to attain and is technique sensitive.

Preferred Sites for Harvesting Bone Grafts for Jaw Reconstruction Surgery

Bone grafts for jaw reconstruction surgery are harvested from three preferred sites. The preferred sites for harvesting bone grafts among different surgeons include the long bones of the legs, hips and ribs.

Harvesting sufficient bone from the hips leads to a deformity in the region. An unsightly scar is usually the result of harvesting sufficient quantities of bone from the tibia.

Ideal Site for Harvesting Bone for Jaw Reconstruction Surgery

The ideal site for harvesting bone for jaw reconstruction surgery is from the rib region. There is complete regeneration of the bone when the periosteal continuity is not compromised following surgery. Scarring is also minimal as multiple grafts can be harvested through a single incision.

Leading Center for Jaw Reconstruction Surgery and Facial Plastic Surgery

Our hospital is a leading center for jaw reconstruction surgery following resection of jaw pathologies. Results from facial plastic surgery have won us many international accolades. We have over 30 years of experience in successfully reconstructing a wide variety of jaw defects.

Types of jaw surgery performed here include orthognathic surgery and surgery for receded lower jaws. Other procedures performed include removal of odontogenic cysts and mandibular osteotomy. Corrective jaw surgery is performed through intraoral small incisions.

We also address radicular cysts, nevoid basal cell carcinoma syndrome, giant cell lesions and fibrous dysplasia.

Patient Referred to our Hospital for Management of the Jaw Pathology

The patient is an 18-year-old female from Cuttack in Odisha, India. She had developed pain and swelling in the right side of her mandible approximately one year ago. The swelling was gradually progressive and greatly alarmed them.

They presented at a local hospital where imaging studies demonstrated a radiolucent lesion enclosing an impacted third molar. The lesion extended from the body into the ramus of the mandible. A diagnosis of dentigerous cyst was made.

She had subsequently undergone enucleation of the cyst. The teeth associated with the cyst were also extracted. Jaw reconstruction had however not been performed. The patient and her parents were very unsatisfied with the treatment.

Unfortunately, the swelling and pain returned approximately four months ago. They had visited another local hospital where imaging studies had been obtained. Diagnosed with a recurrent dentigerous cyst, they were referred to our hospital for management of her recurrent dentigerous cyst.

Initial Presentation at our Hospital for Redo Dentigerous Cyst Surgery

The patient and her parents made their initial presentation at our hospital for her redo dentigerous cyst surgery. Our hospital exclusively uses bone grafts harvested from the ribs. We have successfully performed redo dentigerous cyst surgery for many patients with failed iliac and femoral grafts.

Jaw Reconstruction Surgery followed by Dental Implant Surgery

Treatment planning was explained to the patient and her parents. They consented to the redo dentigerous cyst surgery. She first underwent the redo dentigerous cyst surgery. This was followed by jaw reconstruction surgery using titanium reconstruction plate and rib grafts.

A second procedure was performed four months later. This was dental implant surgery in the reconstructed jaw bone. The time period was to allow for consolidation of the bone grafts with surrounding alveolar bone. The patient and her parents were very happy with the results of the surgery.

Patient Instructed to Return in Four Months for Ceramic Crowns

The patient and her parents were instructed to return in four months for ceramic crowns. This interim period would allow for complete osseointegration of the dental implants to the surrounding bone.

The patient and her patents expressed understanding of the instructions. They were very happy with the level of care given to them at our hospital.

Surgery Video

 


Infected dentigerous cyst – Resection and reconstruction

Infected dentigerous cyst – Resection and reconstruction

Jaw Reconstruction Surgery for Infected Dentigerous Cyst

The lower half of the face comprises the upper jaw and the lower jaw. They aid in speech, eating, and communication. The jaws comprise bones, mucous membranes, nerves, arteries, veins, glands, and other specialized cells. They can be affected by pathological entities such as infected dentigerous cysts and odontogenic keratocysts.

Jaw reconstruction surgery is the preferred treatment for jaws with residual deformities from pathologies. Loss of bone from the jaws can result from a variety of conditions. They can be from trauma, cysts and cancers. Jaw reconstruction surgery enables restoration of both function and esthetics for the affected jaws.

Various Cystic Lesions of the Jaws including Infected Dentigerous Cyst

The dentigerous cyst is the most common odontogenic cyst of the jaws. It is always associated with an impacted tooth. An infected dentigerous cyst is manifested by pain and swelling of the affected region of the jaw. Complete enucleation of the cyst followed by jaw reconstruction surgery is the treatment of choice for this pathology.

Dentigerous cysts are most commonly associated with impacted mandibular third molars. The next most common site of occurrence is with impacted mandibular canines. They can however occur with any impacted tooth. There have been instances where dentigerous cysts have occurred in association with odontomes.

What are Odontogenic Cysts and how do they arise?

Odontogenic cysts are cysts that arise in the jaw from cells that aid in tooth development. They comprise a sac with a distinct membranous lining. They may contain air, liquids or solids. Infected dentigerous cysts have an impacted tooth within them.

The most common odontogenic cysts are radicular cysts. These are followed by dentigerous cysts. Infected dentigerous cysts are often painful and are accompanied by swelling. The next most common cysts are odontogenic keratocysts followed by periodontal cysts. They all commonly result in the destruction of the jaw bone.

Jaw Reconstruction Surgery and Facial Plastic Surgery

Jaw reconstruction surgery is the treatment of choice for the rehabilitation of these patients. This is followed by dental implant surgery to aid in the restoration of function. Jaw reconstruction is a form of facial plastic surgery. Facial plastic surgery involves the restoration of facial deformities. Experienced surgeons provide the best results for facial plastic surgery.

Patients can have jaw deformities due to a variety of reasons. They can be congenital as in cleft palate deformity or can arise due to road accidents. They can also arise due to conditions such as hemifacial microsomia. Jaw reconstruction surgery can be performed through processes such as distraction osteogenesis or usage of bone grafts.

Dental implant surgery is the final step in the rehabilitation of patients who undergo jaw reconstruction surgery. This form of facial plastic surgery not only restores function but also facial esthetics. Dental implant surgery is followed by the fixation of esthetic ceramic crowns to complete the rehabilitation process.

Premier Center for Facial Plastic Surgery in India

Our hospital is a renowned center for facial plastic surgery. We have been rehabilitating patients with facial deformities for over 30 years now. Located centrally in Chennai, which is the capital city of Tamil Nadu, India, we offer excellent results from facial reconstruction surgery.

The patient develops Swelling in Anterior Lower Jaw Region

The patient is a 28-year-old female from Gudur in Telangana, India. She noticed a swelling with pain in the anterior lower jaw at the region of the incisors and canine. As this was progressively increasing, she visited a dental clinic for consultation. Imaging studies were obtained and revealed a retained deciduous canine and an impacted permanent canine.

There was also radiolucency around the crown of the impacted canine. Suspecting this to be a dentigerous cyst, the patient was referred to our hospital for management. She was diagnosed with an infected dentigerous cyst associated with the impacted canine.

Initial Visit at our Hospital for Management of her Infected Dentigerous Cyst

Dr. SM Balaji, Jaw Reconstruction Surgeon, examined the patient and ordered imaging studies and biopsies. This returned with the diagnosis of an infected dentigerous cyst. Treatment planning was explained to include harvesting of bone grafts and dental implant surgery. The patient expressed understanding and consented to surgery.

Rib bone grafts were first harvested from the patient. This was followed by enucleation of the dentigerous cyst along with the impacted canine tooth. Teeth overlying the dentigerous cyst were also extracted. The resultant bony defect was reconstructed using rib graft and titanium screws.

Instructions to Return in Four Months for Dental Implant Surgery

Instructions were given to the patient to return in four months. This would allow for the complete consolidation of the bone grafts with the surrounding alveolar bone. She returned in four months as instructed for dental implant surgery. Dental implants were placed in her reconstructed jaw as per protocol. She was then instructed to return in four months’ time for ceramic crowns. This would allow for osseointegration of the dental implants to the surrounding bone.

The patient and her family were extremely happy with the level of care at our hospital. She expressed understanding of the instructions and will return in four months for her ceramic crowns.

Surgery Video


The Best Steroids for Weight Loss

Among those who decided to gain muscle mass, it is believed that so-called anabolic steroids can help achieve quick and high results. Of course, these drugs contribute to the achievement of a certain effect, but before you start taking them, you need to know and understand what they actually are, all their pros and cons. Photos before and after steroids for weight loss of girls and men can be viewed in the article. For reference https://italiafarmaci.com/ you can find a wide range of steroids for any purpose and course.

What are steroids and what are they for?

At their core, steroids are preparations based on the male hormone testosterone, which is actively involved in the synthesis and production of proteins necessary to “build” muscle mass. It is a mistake to assume that steroids are used only in bodu Since their artificial synthesis in the early 30s of the secolo

The effects of steroid drugs are divided into androgenic and anabolic.

These effects differ from each other in the specific manifestations that are achieved with their use, namely:

With the increase in the effects of androgenic steroids, sexual function is improved, there is intense hair growth according to the male principle (that is, on the chest, legs, face), an increase in body weight can be observed due to water retention in the body. In addition, it is the androgenic component of steroids that can provoke side effects from taking medications (for example, hypertension, irritability).

The anabolic effect is to increase muscle mass, increase endurance, produce less fat, strengthen bone tissues. The ratio of anabolic to androgenic in each individual steroid drug is determined by the so-called anabolic index.

Triiodothyronine

Triioditronine is a hormone synthesized by the thyroid gland. But it is worth noting that the thyroid gland secretes this hormone in small amounts, it is achieved mainly due to the iodation of thyroina This slimming steroid for men and women, as well as tiroina

This hormone is responsible for regulating the supply of oxygen to tissue cells, thereby increasing the overall level of metabolism. In small doses, triioditronine, supplying cells with oxygen, causes their active growth and repair. In large doses, this hormone greatly increases the overall level of metabolism, as a result of which the breakdown of cells begins, with the release of a large amount of energy. This feature of the hormone is used quite often in the world of sports: large doses of triioditronine cause breakdown of adipose tissue, which leads to weight loss.

In medicine, this hormone is often used only in small doses to activate the restoration of damaged tissues, as a rule nervous. Among other things, this steroid hormone has an effect on the absorption of vitamins A and B12, and also participates in the elimination of cholesterol from the body.

“Clenbuterol”

“Clenbuterol” (Clenbuterol) – a product that is used in medicine for the healing of bronchial asthma. In recent years, the drug has found wide use in bodebuilding and fitness, due to its ability to burn fat, so it is often used by athletes to lose weight and dry. Tablets of the best steroid for weight loss contain tiroina “Clenbuterol” is not related to heavy anabolic steroids and belongs to a group of adrenomimetics that show a related physiological influence.

Reconstruction of upper jaw with Rib Graft

Reconstruction of upper jaw with Rib Graft

Importance of Jaw Reconstruction surgery following Trauma

The jaws play a very important role in the maintenance of overall good physical and mental health. They give form to both the middle face and the lower face. Good symmetrical jaw structure plays a vital role in the holistic well-being of the person. They not only aid in speech and eating but are also vital for the esthetics of the facial region.

When this balance is disrupted either through disease or trauma, reconstructive surgery helps in reestablishing normalcy. Reconstruction of the upper jaw and lower jaw are exacting surgeries, which require a high level of skill. Experienced facial plastic surgeons provide the best results for jaw reconstruction surgery.

Role of Oral and Maxillofacial Surgeons in Facial Plastic Surgery

Oral and maxillofacial surgeons specialize in surgeries of the maxillofacial complex. They undergo a specialized training that involves cosmetic, trauma and cancer surgeries. Facial plastic surgery is also performed by them. Experienced surgeons of this specialty obtain the best results from jaw reconstruction surgery.

Treatment Modalities in Jaw Reconstruction Surgery

Various treatment modalities have been developed over the years for performing jaw reconstruction surgery. They include the usage of bone grafts and rh-BMP2, distraction osteogenesis, Le Fort osteotomies and sagittal split osteotomies. The best surgeons are able to visualize the final results beforehand and plan the surgeries accordingly.

Conditions that Require Jaw Reconstruction Surgery

Jaw structure can be compromised due to a variety of factors. They include pathological, trauma and developmental. All these causes lead to a compromise in the overall quality of life for the patient. Modern surgical techniques have advanced to the point where the compromised jaw structure can be corrected through jaw reconstruction surgery.

Bilateral sagittal split osteotomy is performed for the receded lower jaw. Correction of craniofacial anomalies including orthognathic surgery is performed by Craniofacial surgeons. Cleft palate repair and cleft lip repair are performed by facial cosmetic surgeons. These are congenital defects present at birth.

Mandibular osteotomy is performed to reduce an oversized lower jaw. This is a form of corrective jaw surgery. Surgery is performed through small incisions made intraorally. Many of these cases require orthodontic treatment before and after surgery for fine-tuning of occlusion. Plates and screws are used to stabilize the site of the osteotomy.

Many pathological processes lead to compromise in the structure of the jaws. The tumours and cysts like ameloblastoma, odontogenic keratocysts, dentigerous cysts and osteosarcomas. Conditions such as hemifacial microsomia, congenital micrognathia and fractures caused by trauma also lead to jaw deformities.

Jaw Reconstruction Surgery as a part of Facial Plastic Surgery

Jaw reconstruction surgery is only one aspect of facial plastic surgery. Rhinoplasty, scar revision surgery, microtia surgery, facial asymmetry surgery and facial reanimation surgery also form a part of facial plastic surgery. All these surgeries are technique sensitive and take years of dedication and hard work to master.

Medical Tourism Destination for Jaw Reconstruction Surgery

Our hospital is a premiere center for facial plastic surgery in India. We are a super specialty surgical center for jaw reconstruction surgery. Our hospital has been a destination of choice for patients coming for facial surgery from around the world. We offer world-class services at a very nominal cost compared to hospitals in the developed nations.

Our hospital has won numerous awards for providing good results consistently for over three decades now. We are the affiliate surgery center for many international foundations around the world. This has been made possible by the dedication and hard work of Dr. SM Balaji. It is the result of his vision to provide world-class treatment in a third-world setting.

Extensive Facial Deformities due to Road Traffic Accident

The patient is a 36-year-old male from Raipur in Chattisgarh, India. He was involved in a horrific multivehicle road traffic accident a few years ago. This resulted in extensive panfacial fractures, which left him with extensive facial deformities and functional compromise. He had suffered frontal, orbital, zygomatic, maxillary, and mandibular fractures.

He has undergone multiple surgeries in several hospitals in the past, but none of these surgeries were successful. They had resulted in worsening of his functional difficulties and facial esthetics. He had subsequently become depressed as the surgeries only compounded the problems caused by the road traffic accident.

Referral to our Hospital for Surgical Management of Facial Deformities

Realizing that the problem had to be addressed, his family conducted extensive inquiries for the best hospital to treat him. Many of the doctors they contacted referred them to our hospital. Convinced that our hospital was the best surgical center to address his problems, they presented to our hospital for an initial consultation

The treatment plan for surgical management of facial deformities caused by the previous surgeries was presented to them. It was explained that this would involve multiple surgeries that had to be spaced to obtain the best results. They were informed that the first surgery would be maxillary reconstruction using rib grafts harvested at the time of surgery.

Successful Reconstruction of Maxilla with Rib Grafts

He underwent successful reconstruction of the maxilla using rib grafts that were crafted to reconstruct the bony defect. There was a complete failure of the rib graft that had previously been placed in his hometown. The new rib grafts resulted in symmetry with the contralateral side of his maxilla.

It was explained to them that this was just the first step of his rehabilitation. He would need to return in four months for a zygoma implant following the consolidation of rib graft with the surrounding bone. The facial asymmetry that had resulted from the previous surgeries would be corrected by a series of surgeries.

Total Patient Satisfaction from Treatment at our Hospital

There was total patient satisfaction with all his family members expressing their happiness at the results of the surgery. They expressed understanding that they had to return in four months for the next surgery. The patient and his family thanked the staff before discharge from the hospital.

Surgery Video


Unilateral Cleft lip repair

Unilateral Cleft lip repair

Unilateral Cleft Lip Repair for Children with Cleft Lip Deformity

Cleft lip deformity can occur with varying severity. It can range from very mild to very severe. Most severe is the bilateral cleft lip and palate deformity. There is also a hole in the roof of the mouth in the upper jaw. The mildest form is the unilateral incomplete cleft lip deformity.

Ear infections are common in these children. The infection is transmitted through the Eustachian canal. These infections are controlled once the surgical repair is performed. Hearing problems subside following surgery.

The mildest form of cleft lip deformity is unilateral cleft lip deformity. It involves only one side of the lip and does not involve the alveolus or the palate. Unilateral cleft lip repair is the only surgical repair required for these children. The upper lip and nose is affected in cleft lip deformity.

Ramifications of Bilateral Cleft Lip Deformity on Quality of Life

The most severe manifestation of the deformity is the bilateral cleft lip and palate deformity with a free-floating premaxillary segment. A bilateral cleft lip deformity not only affects the esthetics but also the functional aspects of eating and speech. Rehabilitation for patients is usually lengthy and involves undergoing multiple surgical procedures.

First Attempts at Cleft Lip Surgery in Antiquity

Children born with cleft lip deformity often faced a very difficult life during ancient times. The Chinese were the first to attempt a rudimentary cleft lip surgery. Results from the surgery were varied with some very good results at times. History records a member of a royal family with a cleft lip deformity who had undergone successful surgical correction.

Reaction to Cleft Lip Deformity in the Ancient Past

Scientific temper developed only over the last 500-600 years around the world. The Renaissance played a very important role in developing the correct mindset towards life. Children born with a cleft lip deformity were viewed with suspicion in the ancient past. People associated them with the occult and rejected them.

Role of India in the Development of Facial Plastic Surgery

Susruta who is considered to be the father of facial plastic surgery lived in ancient India. Cutting off of the nose was a common punishment meted out to criminals. He was the first to advocate the use of forehead flaps for the reconstruction of nasal deformities arising from such punishments.

Rehabilitation of Cleft Lip Deformity through Modern Surgery

It was only after the advent of the modern age that cleft lip deformity correction was performed with finesse. Postsurgical scarring is also minimal with good esthetic and functional rehabilitation. Experienced surgeons offer very good results with complete patient satisfaction. Plastic surgeons also perform this surgery.

Lengthy Rehabilitation following Cleft Lip Surgery

When the cleft lip and palate deformity is severe, it often involves a lengthy rehabilitation. It involves undergoing a series of surgery to attain normalcy. The first is cleft lip surgery, which is performed at 3-1/2 months of age. This is followed by cleft palate surgery at 10 months of age.

The third surgery is the closure of the cleft alveolus at 4-1/2 years old through the use of bone grafts. This is followed in later years with maxillary advancement, scar revision and other such surgeries as needed. Speech therapy is also an integral part of the rehabilitation of cleft lip patients.

Experienced surgeons offer the best results for cleft lip surgery. The alar base also needs to be reconstructed. They are adept at molding the delicate soft tissue structures of the cleft lip and palate. It is not only a surgical science but also an art that involves an artistic eye for symmetry and proportions.

Center for Excellence in Facial Plastic Surgery and Cleft Lip Surgery

Our hospital is a renowned center for cleft lip surgery for over three decades now. We have been offering our services to patients from around the world. Many patients from Western nations including USA, UK, Germany and France come to us for facial plastic surgery.

We are the only Indian affiliate of the International Cleft Lip and Palate Foundation (ICPF) of Japan.  Our hospital is also the only Asian affiliate of the Dallas-based World Craniofacial Foundation (WorldCF) of the USA.

Baby Girl born with Unilateral Cleft Lip and Palate Deformity

This infant is from Shimla in Himachal Pradesh, India. She was born with a wide unilateral cleft lip and palate deformity. Her parents requested that they wanted the best treatment for their baby. They were then referred to our hospital for cleft lip surgery.

Initial Consultation and Treatment Planning in our Hospital

The treatment planning was explained to the parents in detail. They were given the “Advanced Treatment for Cleft Lip and Palate.” This is a concise handbook for parents authored by Dr. SM Balaji. Her parents expressed understanding of the same and consented to surgery

Successful Surgical Correction of her Cleft Lip Deformity

Surgery is performed under general anesthesia. She underwent cleft lip surgery at the age of 3-1/2 months. The floor of her nose and nasal sill were rebuilt with a C-flap. A meticulous approximation of the cleft lip was then performed in a three-layer closure. The structures of the lip to include the orbicularis oris, subcutaneous tissue and skin were perfectly aligned using a surgical loupe.

There were very good function and esthetic results from this surgical technique. Her parents were instructed to return when she was 10 months old for cleft palate repair. They expressed understanding of the instructions and thanked the hospital staff before discharge.

Surgery Video