CLEFT LIP & CLEFT PALATE

One of the commonest birth defects or congenital deformity involves paring or cleft of the upper lip on either or both sides. The floor of the nose and the hard or the soft palate may also have cleft to varying extent.
The corrective surgery is done in stages starting around three months of age depending upon the general physical condition of the baby.
Results of the surgery: General looks of the patient are improved to a great extent after the lip continuity is restored. Surgery of the palate helps to improve symptoms like regurgitation of food & liquids from nose and development of speech.

CRANIO-FACIAL DEFECTS

The child is born with several defects involving the bony framework and the soft tissues of the skull and face. There may be a single defect or combination of several deformities. Some such defects are: crouzon’s disease, Apert’s syndrome, craniofacial microsomia, mandibulofacial dysostosis etc.
The surgery is done by plastic surgeons especially trained for cranio-maxillo-facial surgery and involves multispeciality inter disciplinary approach. Several sessions at varying intervals may be required. Timings of the surgery depend upon nature of the defect and condition of the patient.
Results of the surgery: Brings about very good changes in the overall appearance.

PTOSIS OR DROOPING EYELIDS

One or both upper eyelids may be drooping to varying extent since birth. The condition may also be acquired following injury or other disease process. The child is unable to lift the affected upper eyelid and has to raise the neck to view around. The corrective surgery is done before school going age or when the patient reports.
Results of the surgery: In most of the cases a near normal looks can be achieved.

DEFECTS OF THE EARS

One or both ears may have varying defects. The ear may be absent, rudimentary, cup shaped, too large, fan shaped, crumpled or bat ear shaped. There may be extra appendages, tubercles or missing or large ear lobule. Such defects are present alone or in association with other defects of skull and face.
Single or multistage surgeries are required to correct the deformity.
Results of the surgery: Some of the defects can be totally removed while others show varying degree of improvement.

HAND & FINGER ANOMALIES

The individual is born with extra finger or thumb or one or two extra digits (polydactyly). There may be missing or fused fingers (syndactyly). Finger may show abnormal bending at normal joints. The size of the finger or toes may enlarge several times more than adjoining digits (macrodactyly). Sometimes deep grooves are present on the digits. All such cases are operated early in life.
Results of the surgery: Generally good.

GENITAL DEFORMITIES

The commonest genital defect in males is abnormal opening of the external urinary meatus or hole. This is termed as hypospadias or epispadias depending whether the opening is on the under surface or over the penis. Hypospadias i.e. opening under and short of the normal tip is mostly associated with curvature or bending of the penis. The child passes urine in the downward and backward direction. The external opening may be small and constricted. The size of the penis may also be small. Absent vagina in female child also requires plastic surgery.
Plastic surgery is done around three to five yeas of age for hypospadias. Single or multistage procedures are done. Reconstruction of vagina is undertaken at or near puberty.
Results of the surgery: The surgery helps to straighten the penis making it sexually functional and the abnormal opening is restored at or near the tip. Vaginal reconstruction helps to restore the female identity.

BIRTH MARKS

Black or hyperpigmented large moles or nevus are present any where on the body. These may be hairy when they are termed as hairy nevus. There can be red or pigmentary lesions that are either raised or flush with the skin surface. These are abnormal lesions arising from blood vessels and are called haemangiomas.
The surgery is mainly done for cosmetic purpose or if the lesion is growing and causing some problem.
Results of the surgery: most hairy nevi and other lesions are removed and replaced by skin grafts or skin flaps. Treatment with Laser also helps in vascular lesions. The results depend upon type of lesion but generally are good.

SPINAL CANAL DEFECTS

Due to this defect the child has swelling or protrusion anywhere along the spine. This protrusion incorporates spinal chord coverings and cerebrospianal fluid and varying amount of nerve tissue. Depending upon the contents it is termed as meningocoele, meningomyelocoele or encphalocoele if brain tissue is also incorporated.
Sometimes there is no protrusion but a tuft of hair at the back.
Results of the surgery: The surgery is done early and is aimed at closing the defect in the spinal canal. The results depend on the nature of the defect. Any hairy patch can be removed effectively by skin grafting.

FACE INJURIES

All the wounds or cuts involving the forehead, eye brows, eyelids, cheek region, nose, ears, lips etc. are best treated by plastic surgery. All fractures involving the facial bones like forehead, orbits, nose, zygoma (cheekbones), upper jaw and the lower jaw or the mandible are treated by special techniques of plastic surgery i.e. maxillo-facial surgery.
Results of plastic surgery: Any injury resulting in skin loss or deformity if treated primarily by a plastic surgeon results in a much better and finer recovery. It avoids later complications and future surgeries.

HAND & FINGER INJURIES

Simple household cuts to hand and fingers. Finger tip injuries, injuries to the tendons, nerves, blood vessels and skin loss. Industrial crushing injuries associated with fractures of the bones, severe skin damage or a totally mangled hand require plastic surgery intervention.
Results of the surgery: Primary intervention by a plastic surgeon enables immediate skin and soft tissue coverage and repair of all-important structures. This helps to salvage the damaged fingers or the hand. The main aim is to restore an functioning hand.

INJURIES TO THE LIMBS

Injury to the upper or the lower limbs especially when associated with loss of skin and soft tissue coverings with or without bony fractures require attention of plastic surgeons.
Results of the surgery: Skin coverage in severe limb trauma can save the limbs from possible amputation. The bone surgeon can perform immediate fixing procedures after plastic surgeon can assure soft tissue coverage to the exposed bone.

AMPUTATIONS

Total or partial amputations of fingers, hand, arm etc. due to any accidental injury require reimplantation surgery.
Results of the surgery: Microneurovascular reanastmosis or reunion if done immediately or within a few hours can restore the severed part.

BURNS

Acute or fresh burns from direct flames, hot liquids, acids, electricity flash etc. require urgent care. In some instances skin cover is required within a few days to prevent life threatening complications. During the course of healing after burnt skin or slough has been removed urgent skin cover can prevent bad contractures and ugly scar formations. Some patients report very late with extensive scars and functional deformities. All such cases require one or several plastic surgery procedures to correct the defects.
Results of the surgery: Plastic surgery for burns is not only life saving at times but prevents several complications. Aesthetics of the burnt part is improved.
Lost functions like normal movements of any part which are vital for daily chores are effectively restored. The inactive depressed burnt victim can be brought back to society mainstream by plastic surgery procedures.

Accidental injuries, burns or previous surgery can result in unsightly scars. Such deep or hyperpigmented scars when present on the visible areas can be socially embarrassing. Scar revision surgery is done for such cases.
Results of the surgery: Marked improvement in the looks of the scar is achieved after most scar revision surgeries. The scars are made much finer, their direction changed suitably to make them less or least noticeable. The scars however can never be eliminated.

PRESSURE SORES

Prolonged pressure on a particular skin region results in the breakdown and wound or ulcer formation. Such chronic ulcers are commonly seen in spine injuries when the patient is unable to move on his own. Areas of bony prominence like lower back (Sacrum, ischium), upper outer thigh region (trochanter), etc. are involved. Reconstructive plastic surgery by skin grafting or skin flaps is done.
Results of the surgery: Surgery is done to remove all the dead tissues and resurface the raw area with good quality skin cover. Majority of ulcers heal after the surgery. Recurrence of lesion is there if effective measures are not taken to prevent prolonged presure.

AGEING DEFECTS

Wrinkles on the face and forehead a natural sequel of old age could be disturbing to many individuals. Some persons may have premature wrinkling giving them a very aged look. Deep frown lines, drooping eyebrow, drooping upper eyelids, crowfoot lines at the outer side of eyes, bagginess of the lower eyelids wrinkles around the mouth and lips, jowls, hanging cheeks, double chin, neck bands, and wrinkled neck can all lead to psychological and personality changes apart from taking away an individual’s young looks.
Conventional cosmetic surgery or laser assisted skin resurfacing helps to improve or eliminate all above-mentioned defects
Results of the surgery: Face-lift or Rhytidectomy along with Forehead lift can take care for most of the wrinkles. Eyelid surgery or Blepharoplasty can relieve the tired looks due to drooping & baggy eyelids. Liposuction can markedly improve the double chin. Most of these procedures last for about five to ten years and in the immediate postoperative period the person looks rejuvenated and younger.

NOSE JOB

Nose, the most prominent part of the body draws everyone's attention.Alteration in shape of the nose or rhinoplasty is thus the most important and frequently asked for procedure in cosmetic surgery. a large nose with a hump, depressed nose, long or short nose, irregular or crooked nose, nose with broad or bulbous tip and post injury defect or deviated nose are common problems.Plastic surgery for correction of these defects is usually a day surgery procedure done under local anesthesia.
Results of the surgery: Rhinoplasty or nose reshaping surgery is both most demanding and rewarding surgery. If the patient knows what results to expect and the surgeon experienced enough to explain the actual changes that can be brought about the results are highly satisfying and encouraging. The operating surgeon and the patient must discuss and analyse the importance of altered body image following this surgery.

OBESITY

Some individuals may be generally obese and overweight while others have localized fat deposits deforming the normal body contours. Pot belly, loose hanging abdomen, hanging upper arms, hip rolls, love handles, altered waist line, heavy and drooping buttocks, fat deposits on the sides of the thighs etc. are common problems for which people seek help of plastic surgery.
Results of the surgery: Dermalipectomy or removal of the loose extra skin flaps with underlying fat and suction assisted lipectomy (liposuction) can restore the body contours. This surgery gives promising results.

BALDNESS

Premature loss of the scalp hair may be hereditary or associated with some illness. Many individuals also contest Balding due to old age.
Plastic surgery is done to restore the missing hair by transplanting one’s own hair taken from back of the scalp. Several new techniques have evolved in the field of hair transplant.
Results of the surgery: The transplanted hair grows normally and the stigma of being called a bald person is over. The transplanted hairs however lack the thick density, as the donor area at the back is not sufficient to cover the entire head.

BREAST DEFECTS

Some young males can have abnormal enlargement of their breast tissue(gynaecomastia). In females, small sized breasts, unequal breasts or very heavy breasts and post pregnancy ptosis can be a matter of concern. Removal of breast in the event of cancer surgery can be a great mental trauma. Plastic surgery helps all such cases.
Results of the surgery: In male gynaecomasia entire abnormal breast tissue can be removed. In females, breast reduction brings a great relief to those with heavy breasts. Breast enlargement is commonly done with implants and good cosmetic results are achieved. Mastopexy corrects the drooping pendulous breasts. Surgically removed breasts are reconstructed by various methods.

WHITE OR HYPOPIGMENTARY DEFECTS (VITILIGO)

A vitiligo patch especially on the exposed parts is a matter of great concern more so in dark races of Asian origin. Some localized patches that do not show any changes over a long period of time are treated by plastic surgery.
Results of the surgery: The stable white patches are removed and replaced by normal looking skin grafts. On large areas, superficial abrasion and pigment cell transfer brings about good cosmetic results.

ALTERATIONS OF EXTERNAL FEATURES

Some individuals may ask for alterations in their facial features such as; changing the thickness of lips, reducing or raising the cheek bones, reducing or enlarging the size of the chin, reducing the wide angles of mandible, pushback of protruding upper jaw and teeth. Some Orientals may ask for upper eyelid fold and elimination of epicanthal skin folds of the eyes. Creation of artificial dimples is yet another demand of some individuals.
Results of the surgery: Cosmetic plastic surgery enables to meet all above mentioned goals to a large extent.