Bilateral Cleft Lip and Palate Surgery with Tiny Prolabium

Bilateral Cleft Lip and Palate Surgery with Tiny Prolabium

Occurrence and Etiology of Cleft Lip and Palate Deformity

A cleft lip and palate deformity is a congenital defect that is the most common birth deformity. This defect is seen in approximately every 2 infants out of 1000 live births. It can occur in isolation or in association with a syndromic presentation. Genetic mutations are the most common cause of these syndromic presentations.

These defects are found in Pierre Robin sequence, Stickler syndrome and Treacher Collins syndrome amongst others. Other factors can also lead to the intrauterine development of the cleft lip and palate deformity. They include maternal smoking, secondhand smoke, diabetes, obesity and advanced maternal age.

Usage of contraindicated medications during pregnancy can also lead to this deformity. Maternal use of seizure medications is a common cause of this defect.

Ongoing Research regarding the Role of Modern Technology and Congenital Defects

Modern technology has brought a whole new range of factors into play. These too need to be considered as an etiology for the development of cleft lip and palate. Research is still underway regarding the role of radiation emitted by modern devices in the development of this deformity.

A cleft lip is nonfusion of the two halves of the upper lip. This can either be unilateral or bilateral in presentation. There is gross facial deformity arising from this condition. Children with cleft lip deformity can develop psychological problems in later life if the condition is left unaddressed.

This deformity results in both cosmetic as well as a functional compromise for the affected infant. Surgical repair is the only treatment option. Children might need a few additional surgical procedures as they grew up.

Cleft palate deformity is caused by nonfusion of the two halves of the palate. This results in a hole in the roof of the mouth. Feeding difficulties arise from this as the infant is not able to create the vacuum needed for suckling. There is a regurgitation of fluids into the nasal cavity.

Hard Earned Reputation at the Best Cleft Lip Surgery Hospital in India

Our hospital is considered to be the best cleft lip surgery hospital in Chennai as well as in the entire nation. This has also intrinsically made us the best cleft palate surgery hospital in Chennai. The soft palate is also involved in this deformity. These two conditions are the most common congenital defects in the world today.

We have been performing cleft lip surgery and cleft palate surgery for over 30 years now. Many pan-Indian surveys have named us as the best cleft palate surgery hospital in Chennai. We are also recognized as the best cleft lip surgery hospital in Chennai as well as India by many international organizations.

Dr. SM Balaji is regarded as the best cleft lip surgeon in Chennai, India. He has been credited with numerous surgical innovations in cleft lip and palate surgery. These innovations have become a standard surgical practice in hospitals around the world. His services as much sought after by many nations around the globe. They include the USA, Germany, Japan, Sri Lanka, and the Maldives amongst many others.

He has been recognized as the best cleft lip surgeon in Chennai as well as the whole of India. This has been made possible through hard work and dedication towards providing surgical care of international standards to everyone. His vision and guidance have made us the best cleft lip surgery hospital in Chennai.

International Acclaim for the Surgical Services in our Hospital

Our hospital is the tertiary referral center for the International Cleft Lip and Palate Foundation (ICPF) of Japan. We have also been chosen as the Asian referral center of the Dallas-based World Craniofacial Foundation (WorldCF) of the USA. Children from around the world are referred to us due to the high level of surgical care for afflicted infants.

We are often feted as the best cleft lip surgery hospital in Chennai by our peers. We have one of the best cleft teams in the world today. Speech therapists are also an intrinsic part of this team. We understand the needs of children with cleft deformities.

Numerous awards including the prestigious Dr. BC Roy award stand testament to the levels of surgical care provided by our hospital. We are also synonymously considered to be the best cleft palate surgery hospital in Chennai, India.

Complications Caused by Delay in Getting Surgical Treatment

Speech impediment is commonly caused by this disorder if there is a delay in getting this addressed. It is imperative to get these defects corrected surgically at the right time. Speech develops normally in children who have been operated on at the right time. The ideal time for cleft lip surgery is 3-12 months and cleft palate surgery is at 10 months old.

Children who have undergone surgical repair of cleft lip and palate can require cleft speech therapy. This will ensure that there is completely normal speech, which will help the child integrate completely into society. We provide guidance to parents regarding referral for cleft speech therapy for their children.

Little Boy Born with Severe Cleft Lip and Palate Deformity with Tiny Prolabium

This little boy is from Thiruvarur in Tamil Nadu, India. He was born with a severe bilateral cleft lip and palate deformity with a tiny prolabium. His parents were initially very upset by this. Staff members at the hospital counseled his parents extensively regarding his care.

Parents expressed the wish that they wanted the best possible treatment for their newborn son. They were then referred to our hospital for surgical correction of his deformities. Parents were advised to book an appointment in our hospital. They contacted our hospital manager and an appointment was made. His parents then presented to our hospital when he was 3-1/2 months old.

Treatment Planning Explained in Detail to Parents

Dr. SM Balaji, cleft lip and palate surgeon, met with the parents. He listened to them patiently and answered all their questions. Speaking from his vast experience, he explained to them that they had nothing to fear from this condition. They were very relieved and happy following their interaction with him.

Surgical Correction of Bilateral Cleft Lip Deformity

Treatment planning was explained to his parents in detail and they consented to surgery. It was decided to perform a single-stage cleft lip repair surgery utilizing Paul Black’s technique. Considering the size of the tiny prolabium, no cross incision was made at the prolabium.

The available prolabium and columella were then mobilized for the reconstruction of his philtral column and formation of Cupid’s bow.

This was then followed by meticulous reconstruction of his nasal floor and vermillion using bilateral C-flaps. This was followed by a meticulous three-layer closure of the cleft lip using a surgical loupe for magnification. The orbicularis oris muscle was next approximated followed by an approximation of the subcutaneous tissue and skin.

Instructions Provided to Parents regarding Cleft Palate Repair

Parents were very happy with the results of the surgery. They were then instructed that they needed to return when he was 10 months old for cleft palate repair. They expressed understanding and thanked the hospital staff before discharge from the hospital.

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Odontoma Nerve Compression Removal and Reconstruction

Odontoma Nerve Compression Removal and Reconstruction

Odontoma Removal and Reconstruction

What is an Odontome and how is it formed?

An odontoma is a benign tumor, which is linked to the abnormal development of a tooth. It is a hamartoma and is composed of irregularly placed normal tissue. This can involve both hard tissue as well as soft tissue. Odontoma was the previously used terminology for an odontoma.

Most Frequently Diagnosed Age Group for Odontome

This condition is most commonly diagnosed during the early teenage years. It is most commonly incidentally diagnosed when there is a delayed eruption of a tooth. Odontomes are frequently associated with unerupted teeth. They are rare instances of eruption into the oral cavity.

Extraction of the unerupted odontoma is the usual treatment of choice. This is akin to surgical removal of impacted third molars. Impacted mandibular odontomas are usually found deeper in the jawbone, being in close proximity to the inferior alveolar nerve. An improper surgical technique can lead to damage to the nerve.

Successful extraction of an impacted mandibular odontoma requires a lot of experience. The best possible results are obtained by surgery performed by experienced oral and maxillofacial surgeons. Oral surgery is one of the specialties of dentistry. Our dental clinic in Chennai is a premiere center for oral surgery.

Hard Earned Reputation as the Best Wisdom Tooth Hospital In Chennai

Dr. SM Balaji, the Oral and Maxillofacial Surgeon, has over three decades of experience in dealing with extraction of impacted teeth. Our hospital is considered to be the best wisdom tooth surgery hospital in Chennai. We perform chair-side wisdom tooth surgery for simple cases. Extraction of complicated impacted wisdom teeth is performed in the operation theatre under general anesthesia.

Our expertise in ensuring the best possible surgical results for patients is hard-earned. This has earned us the title of best wisdom tooth surgery hospital in Chennai from both our peers and patients alike. We handle the most complicated cases of impacted wisdom teeth. They even present near the lower border of the mandible as well as near the orbital cavity.

We have been named the best wisdom tooth surgery hospital in Chennai by a recent survey by a leading newspaper. The survey has also named us as being the best wisdom tooth surgery hospital in India. This high honor has been made possible by our commitment to excellence and ensuring total patient satisfaction.

Best Tooth Extraction Hospital in Chennai

Our hospital is amongst the leading dental hospitals in India. We are the destination of choice for the best dental treatment in Chennai. Many patients come from around the world for dental treatment at our hospital.

Our hospital is equipped with the latest technological advancements to offer the best possible treatment for our patients. The dental services provided by our hospital are amongst the best in the entire nation. We are a tertiary center for specialized world-class dental care in India.

Patient Presents to our Hospital for Definitive Treatment of Odontome

The following case is a description of a patient who came to our hospital for treatment of an odontoma. There was also compression of the inferior alveolar nerve by the odontoma. The odontoma was extracted with minimum trauma along with an associated impacted tooth. There was no compromise of nerve function following the surgery.

Failure of Initial Treatment Elsewhere for the Patient

The patient is a 25-year-old female from Gingee in Tamil Nadu, India. Around 18 months ago, she had presented at a local hospital with pain and mild swelling in her mouth. This was at the site of a missing first molar tooth on the right side of her lower jaw. Imaging studies had been obtained, which revealed an impacted first molar and a partially formed second molar.

There was a radiopaque shadow around the second molar. The second molar tooth was in close proximity to the inferior alveolar nerve. This was diagnosed as an odontoma and extraction were recommended to the patient. However, the attempt to extract the two teeth was abandoned midway with the removal of the crown of the impacted first molar. There was no occurrence of a dry socket.

The patient was advised to seek treatment at a super specialty center but failed to do so. It was only 18 months later that the patient presented to our hospital. The swelling and pain with paresthesia at the site of the attempted extraction forced her to address this.

Initial Presentation and Treatment Planning at our Hospital

Dr. SM Balaji, Wisdom Tooth Impaction Surgeon, examined the patient and ordered imaging studies. This revealed the first molar with the missing crown and a partially formed second molar. The second molar was diagnosed as an odontoma.

There was also a draining sinus at the site of the attempted extraction. Compression of the nerve by the odontoma was diagnosed as the cause for her paraesthesia. Treatment planning was explained to the patient and her attendants in detail. She expressed understanding and consented to undergo surgical removal of the impacted teeth.

The patient was taken to the operating room and anesthesia was induced. Prepping and draping were done to have the wisdom tooth removed. Tooth removal was preceded by an incision of the gum tissue overlying the region. The impacted wisdom tooth was then exposed following removal of overlying bone.

Both teeth were then extracted followed by debridement of granulation tissue at the site. There was a complete resolution of the patient’s complaints following surgery. A rib bone graft harvested at the time of surgery was used to reconstruct the bony defect at the surgical site. This was fixed with titanium screws.

Postoperative instructions were given to the patient. She will return in six months following complete consolidation of the bone graft with surrounding alveolar bone. Dental implant surgery would be performed at that time with the placement of premium dental implants. Ceramic crowns would be fixed to the dental implants following osseointegration of the implants to the mandibular bone.

The patient was very happy with the level of care at our hospital. She also expressed a complete understanding of the instructions given by hospital staff before discharge from the hospital.

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Everything You Need to know about Microtia Surgery

Everything You Need to know about Microtia Surgery

Centre for Excellence in Microtia Surgery in India

Congenital underdevelopment of the external ear is known as microtia. It is seen in approximately 1 out of 10000 live births around the world. This condition can either be unilateral or bilateral. The right side is more commonly affected when it is unilateral.

It is known as anotia when there is a complete absence of the external ear. Surgical reconstruction of anotia also follows the same principles that are used for microtia repair.

Microtia can vary in severity ranging from grade I-IV. Grade I microtia manifests as a very mild deformity. Grade IV microtia exhibits a complete absence of the external ear and ear canal. The cost of microtia surgery in India varies with the severity of the deformity.

Microtia surgery in India is offered by only a few superspecialty hospitals. The cost of microtia surgery in India is very nominal when compared to the developed Western countries. Microtia correction involves surgical reconstruction of the deformed external ear through ear reconstruction surgery.


Our hospital is a leading facial plastic surgery hospital in India where microtia reconstruction is performed. We have been performing microtia surgery for over 30+ years now. This is one of the specialty cosmetic procedures performed in our hospital.

We have rehabilitated scores of children and adolescents with microtia deformity. Recognized as a premier center for microtia surgery in India, patients from all over the world are referred to our hospital. We have been awarded as a leading facial plastic surgery hospital by many international associations

Possible Etiology behind the Occurrence of Microtia Deformity

Microtia can occur due to genetic defects in either a single gene or multiple genes. There is also a risk of microtia in women with gestational diabetes. It can also be found in conditions like hemifacial microsomia. A mild grade I microtia is difficult to diagnose at the time of birth.

Hearing is also affected in most cases of severe microsomia. Conductive hearing loss is seen in grade II microtia due to stenosis of the external ear canal. It is most severe in grade IV microtia with a complete absence of the external ear canal and the eardrum. Cochlear implants are used to restore hearing for children who are afflicted with the more severe forms of microtia.

Centre of Excellence for Microtia Surgery in India

Situated in Chennai, India, we are a leading center for facial plastic surgery in India. We specialize in facial reconstructive surgery as well as facial cosmetic surgery. Our center is a tertiary referral center for the correction of facial deformities.

Organizations such as the International Cleft Lip and Palate Foundation of Japan and the Dallas-based World Craniofacial Foundation of USA refer patients to us.

This is in lieu of the excellent long-term results for patients undergoing surgeries like ear reconstruction surgery in our hospital. The cost of microtia surgery in India is another factor that makes our hospital the first choice for many international patients.

Our hospital utilizes facial implants for a variety of cosmetic procedures. However, only autologous grafts harvested from the patient are used for microtia surgery. This gives the best results than the utilization of prosthetic ears.

Our hospital is a leading center for the correction of ear deformities. Optimal esthetic results are obtained to ensure total patient satisfaction. Bat ear correction is also performed in our hospital with very good cosmetic results.

Dr. SM Balaji, Ear Reconstruction Surgeon, has over 30+ years of rehabilitating children with congenital defects of the facial region. Our hospital is a renowned center for microtia surgery in India.

Microtia Surgery Utilizing the Two-Stage Technique for Optimal Results

We utilize the two-stage repair for microtia surgery in our hospital. This is a specialized surgical technique for ear reconstruction that is offered only by a few centers offering microtia surgery in India. Surgeons have to undergo many years of training before gaining mastery over this technique.

The first stage involves the harvesting of a costal cartilaginous graft. A template is then prepared using the normal ear as a guide in the case of unilateral microtia.

Construction of symmetrical templates with the creation of cartilaginous structures to recreate the ear is performed for patients with bilateral microtia. The templates help create symmetry in both outer ears through careful crafting of the rib cartilages.

The grafts are then crafted to replicate the structure of the normal ear. This is then inserted into a skin pocket that is created at the site of the deformed ear.

A drain is placed to create negative pressure to prevent the creation of dead space. The shape of the ear framework will be defined without redundancy. Excessive cartilage is banked to be utilized in the second stage repair.

The second stage of surgery is performed in four months’ time. The banked cartilage is first removed under general anesthesia. The cartilaginous structure that was placed in the skin pocket is then raised. The next step entails the utilization of a full-thickness skin graft to recreate the tissue behind the raised ear.

This results in the perfect recreation of asymmetrical ear structure at the site of the deformed ear. The cosmetic transformation is dramatic for the patient.

Leading Center for Facial Plastic Surgery in India

Microtia deformity is often debilitating to the patient. Patients with this deformity, especially children, can face difficulties in social settings as a result of nonacceptance by their peers. This could lead to withdrawal and depression with long-term repercussions.

Our hospital is also a leading research center for facial cosmetic surgery in India. We are considered to be the premier center for microtia surgery in India. Many surgical innovations have evolved in microtia surgery from the research undertaken at our hospital. These innovations have been adopted as the standard operating procedures by many surgeons around the world.

Development of a Dedicated Team for Microtia Surgery in India

Ably led by Dr. SM Balaji, facial plastic surgeon, our surgical team consists of dedicated medical and paramedical staff who have over 30+ years dealing with pediatric patients. Our pediatric anesthesiologists have extensive experience in dealing with children.

Our commitment to providing the best outcomes for our patients is unmatched. We pride ourselves on our dedication and empathy towards all our patients. Utmost importance is given to complete patient satisfaction at our hospital.

All That You Need to Know About Rhinoplasty

All That You Need to Know About Rhinoplasty

What is Rhinoplasty and what are the Indications for Rhinoplasty?

Rhinoplasty is a surgical procedure that is performed to alter the shape of the nose. It is a nose reshaping surgery. This has been performed since time immemorial and is the most common facial cosmetic surgery performed in the world today.

Also referred to as a nose job, this essentially changes the appearance of the nose and improves the overall esthetic appeal of the face. This can be purely cosmetic for the correction of minor deformities. It can also be a life-altering surgery for patients who have nasal deformities arising from cleft lip and palate deformity or trauma to the nasal region.

The popularity of rhinoplasty (nose surgery) has soared over the last 25-30 years with the advent of liberalization of the economy. Improved facial aesthetics leads to greater self-confidence and higher self-esteem for the individual. This automatically leads to a better overall quality of life.

The Development of India as a Preferred Destination for Medical Tourism

India has become a destination of choice for many from around the world due to its high quality of medical care. Many patients flock to the country for cosmetic surgery. In particular, there is a high demand for experienced facial cosmetic surgeons. Another major factor is the economical rhinoplasty cost in India.

Rhinoplasty is one such procedure for which many patients come to our country. This surgery involves alteration of both bone and cartilage. The best rhinoplasty surgeon in India is someone who offers very good cosmetic and functional results for the patient allied with world-class infrastructure and overall level of care. Many surgeons in India perform primary rhinoplasty.

Our hospital is considered to be a center of excellence for rhinoplasty in the country today due to its consistent track record over the years with complete patient satisfaction. Patients refer us to others stating that we are the best hospital for a nose job in India. We are a superspecialty center for the correction of nasal deformities arising from cleft lip and palate deformity.

Best Rhinoplasty Surgeon in India | Surgical Excellence in the Correction of Nasal Deformities

Dr. SM Balaji, Director and Consultant, Balaji Dental and Craniofacial Hospital, Chennai, is considered to be the best rhinoplasty surgeon in India today. This is based on treatment results, patient satisfaction and overall quality of care offered at our hospital in India. He has over three decades of experience in the correction of nasal deformities. Some of the surgical innovations introduced by him have led to improved results and quicker recovery for patients.

Having performed over 25000 rhinoplasty procedures in his career, he is able to intuitively design the nose that best suits each individual patient. The results obtained over the years are a testament to his dexterity and skill. Our hospital is a destination of choice for many international patients who wish to undergo rhinoplasty.

Many patients with nasal deformity not only have compromised esthetics but also compromised function of the nose. The experience of the surgeon is a vital factor in determining the successful outcome of the surgery. Plastic surgeons specialize in this surgery.

Our hospital is a tertiary care center for redo rhinoplasty in India for patients who have had less than optimal results at other surgical centers. Patients with cleft lip and palate deformity who have had compromised results at other treatment centers are offered world-class care at our hospital.

Cosmetic Rhinoplasty for Correction of Nasal Deformities

There are two main surgical techniques for performing rhinoplasty. They are open rhinoplasty and closed rhinoplasty. All incisions are made inside the nose for closed rhinoplasty thus ensuring that there is no visible scarring at the surgical site. Experienced surgeons are able to perform even complex corrective surgery through closed rhinoplasty.

Open rhinoplasty is performed for the correction of deformities with a very complex presentation. This allows greater access to the surgical site and the surgeon is able to directly visualize the structures.

It takes vast experience to be called the best rhinoplasty surgeon in India. With over three decades of experience operating on every possible variety of nasal deformities, our hospital has become synonymous with excellence in rhinoplasty.

Patient Reasons to Opt for Rhinoplasty

Patients can desire to undergo rhinoplasty for a wide variety of reasons. They can range from correction of deformities arising from congenital conditions like cleft lip and palate deformity, nasal deformities caused by trauma or simply cosmetic correction to get the ideal nasal structure.

Classification of Common Nasal Deformities requiring Cosmetic Nasal Surgery

There are a wide variety of nasal deformities. They include a flat nose with a flattened bridge and an extremely wide nose with large nostrils. It could also present as a short nose or an elongated nose. There could be deformities of the tip of the nose like in a parrot beak nose or a crooked nose deformity amongst many others.

Cartilage grafts harvested from the patient are used for the correction of a wide variety of nasal deformities. These grafts are used to augment the bridge of the nose to correct a flat nose, straighten the dorsum of a crooked nose or correct an asymmetrical nose. The nasal cartilages are also trimmed to provide the best possible cosmetic results from the surgery.

Surgery for Broad Nose Correction and Long Nose Correction

Patients who present for this surgery often have nostrils that are excessively wide and reduce the cosmetic appeal of the face. There is also a flattened appearance to the nose due to this deformity. This is corrected by augmentation of the nasal bridge with a graft followed by reduction of nasal width through excision of excess tissue. Longnose correction is obtained by excision of the nasal cartilages to create a nose that is in harmony with the patient’s face.

Correction of Nasal Hump Deformity and Crooked Nose Deformity

Some patients present with a dorsal nasal hump, which reduces the attractiveness of the nose. There is a hump in the nasal bone in these patients. Surgery is performed through the reduction of this nasal hump to straighten the dorsum of the nose. There is a dramatic improvement in appearance following this surgery.

Crooked nose deformity is most often congenital or caused by trauma to the nose. Patients with this deformity are often self-conscious about their appearance and often have breathing difficulties caused by a deviation from the nasal septum. Correction of this deformity often results in a dramatic improvement to their overall quality of life.

Parrot Beak Deformity Correction for Enhanced Facial Esthetics

A parrot beak deformity or Polly beak nose is often characterized by a dorsal hump and a low tip. Its structure resembles that of the upper beak of a parrot. This is mainly a cosmetic procedure. They state that they wish to undergo plastic surgery at the time of presentation. Patients with this nasal appearance are often dissatisfied with their nasal appearance for a long time before presented for corrective surgery.

Though this can be a complicated surgery, the best rhinoplasty surgeon in India who is often vastly experienced in performing such surgeries performs closed rhinoplasty procedures for optimal esthetic results for the patient.


Correction of Nasal Deformities arising from Cleft Lip and Palate

Our hospital is a superspecialty center for cleft rhinoplasty with thousands of successful surgeries having been performed over the years. We are recognized as one of the premier surgical centers for this procedure in the world and Dr. SM Balaji is unequivocally the best rhinoplasty surgeon in India for this procedure.

The Best Overall Surgical Center for Rhinoplasty Surgery in India

We pride ourselves in providing total patient satisfaction for those who undergo rhinoplasty at our hospital. Our surgeon who is ably assisted by a highly experienced team of medical and paramedical staff ensures that the results are esthetically pleasing and functionally optimal for the patient.

Facial Asymmetry Correction with Fat Graft for Parry Romberg Disease

Facial Asymmetry Correction with Fat Graft for Parry Romberg Disease

What is Facial Asymmetry?

When you examine your face in photos or the mirror, you can find that your features are not perfectly aligned. One ear may begin higher than the other, or one side of your nose may have a sharper point.

Asymmetry refers to having features that do not exactly mirror one another on both sides of the face.

Almost everybody has a degree of facial asymmetry. However, some instances of asymmetry are more obvious than others. Asymmetry may be caused by injury, aging, smoking, and other causes. Mild asymmetry that has always existed is considered natural.

However, recent, visible asymmetry can indicate the presence of a serious condition such as Bell’s palsy or a stroke. Continue reading to learn more about the causes of an asymmetrical face, as well as testing and treatment options.

What is Parry–Romberg syndrome?

Parry–Romberg syndrome (PRS) is a rare disorder that causes progressive shrinkage and degeneration of the tissues beneath the skin, typically on one side of the face (hemifacial atrophy), but also affecting other parts of the body.

Facial Asymmetry Correction with Fat Graft for Parry Romberg Disease

This patient first noticed a developing asymmetry due to gradual atrophy of his left lower jaw a few years back and had been diagnosed with Parry Romberg disease. Parry Romberg disease could have a varied etiology including viral, traumatic, nervous system abnormalities or as an autoimmune disease.

He presented to our hospital seeking correction of his facial asymmetry. He was diagnosed to have atrophy of subdermal fat in the left mental/submental region. A full-thickness dermal fat graft was harvested from his inguinal region. This was then inserted into a submental pocket created at the region of the atrophy.

Minimal overcorrection was performed to allow for slight resorption of the fat graft. He was very pleased with the results of the surgery.

Fibrous Dysplasia of Zygoma and Orbit

Fibrous Dysplasia of Zygoma and Orbit

Young Man Notices Gradual Development of Facial Asymmetry

The patient is a 26-year-old man from Thalassery in Kerala, India. He has had a slowly progressing facial asymmetry for many years now. There was a gradually developing swelling of the right midfacial region.

A biopsy had been obtained and he had been diagnosed with fibrous dysplasia. He had chosen to ignore it as it was not causing him any functional difficulties.

Disfigurement caused by Fibrous Dysplasia and its Probable Etiology

Fibrous dysplasia is a rare disorder of the bone where normal bone is replaced by fibrous tissue. There is an overgrowth of this fibrous tissue, which results in progressive facial disfigurement. The bone is also weakened by this fibrous tissue.

It is thought to result from a genetic mutation at birth but is not hereditary. There is a dull ache in the region of the affected bone. Fractures are also common when it affects the limb bones. The only treatment available is the surgical removal of the fibrous tissue.

Patient Decides to Undergo Surgical Correction of his Deformity

The growth has now progressed to the point where it is causing self-esteem problems for the patient. He was beginning to avoid social interactions because of the extreme facial disfigurement. His parents researched the internet for the best hospital to get this addressed. They also made widespread inquiries regarding the same.

Our hospital is a premiere center for facial plastic surgery in India. Many patients have undergone facial cosmetic surgery and facial reconstructive surgery at our hospital. He and his parents zeroed in on our hospital for his fibrous dysplasia surgery.

Our hospital stringently follows protocols laid down by the American Society of Plastic Surgeons. We also conform to the guidelines laid down by the European Society of Aesthetic Plastic Surgery. Many referrals are made from centers in the European Union to our hospital for correction of facial deformities.

Patients from around the world come to us for reconstructive plastic surgery and facial asymmetry surgery. We utilize advanced facial biometric systems for facial asymmetry correction. Facial implants can be utilized when there is a bony deficiency causing facial asymmetry.

Initial Consultation and Treatment Planning at our Hospital

Dr. SM Balaji, facial cosmetic surgery, examined the patient and spoke with him at length. Biopsies and imaging studies were ordered including CT scans. This revealed a diagnosis of fibrous dysplasia of zygoma and orbit along with the involvement of the temporal bone.

The fibrous overgrowth had caused gross disfigurement of both bones. Our hospital also offers comprehensive imaging services including magnetic resonance imaging (MRI) scan and bone scan.

He explained the surgical treatment process and the cosmetic improvement to the patient. All queries raised by the patient and his family were addressed. The patient and his parents expressed understanding and consented to surgery.

A 3D stereolithographic model of the patient’s skull was obtained. The fibrous overgrowth was studied and presurgical analyses were performed. It was then decided to proceed with surgery.

Surgical Removal of Fibrous Overgrowth

The affected regions of the zygoma and temporal bone were approached through a hemicoronal incision. No other approach would enable satisfactory removal of the fibrous tissue. Surgery progressed through dissection of the galea and temporal fascia. Care was taken to also preserve blood supply to the temporalis muscle to prevent any postsurgical atrophy.

The frontalis and orbicularis oculi branches of the facial nerve were protected throughout the surgical procedure. Dysplastic fibrous overgrowth was removed meticulously. Normal bony contour was established through the removal of the excess tissue. This would restore symmetry to his face.

The fascia was sutured with retraction of the temporal muscle after adequate removal. This was to ensure that there would not be a hollowed-out appearance to the region. The incision was finally closed with staples.

Postsurgical Improvement in Facial Appearance

The patient and his parents were very happy with the results of the surgery. There was a tremendous improvement in the cosmetic appearance of the face. Improvement in the patient’s self-confidence was apparent shortly after surgery.

He and his parents expressed their total satisfaction with the treatment process at our hospital.

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We are dedicated to giving each of our patients the healthy smile they deserve!