"Dimple"-matically correct - Revisiting the technique for the creation of a chin dimple.

The boom in cosmetic surgery has ushered in the age of the "designer dimple." In the current scenario where an increasing number of Indians are seeking cosmetic surgery, we present our technique for creation of chin dimples. We used this simple and straightforward technique in one patient. The principal steps of the technique include thinning the skin flap, creating a concave indentation in the mandibular symphysis, and obtaining an adhesion between the thinned skin flap and the indented bone. An aesthetically pleasing chin dimple was achieved. We propose that the bony contouring improves the chances of creating a permanent chin cleft or dimple. Our technique for creation of chin dimples aims to give an aesthetic and permanent result by altering the underlying contour of mandibular symphysis and achieving accurate skin coaptation with non-absorbable sutures.

Median cleft lip: A new method of surgical repair.

The aim is to discuss a new method of muscle repair in midline cleft lip. Three patients with midline cleft lip were repaired with our technique of muscle repair and the results evaluated. Our new method of muscle repair in the form of 'Z' helps in forming the philtral dimple.

Release of oral submucous fibrosis and reconstruction using superficial temporal fascia flap and split skin graft--a new technique.

Long standing oral submucous fibrosis is associated with involvement of the oral submucosa and the muscles of mastication leading to difficulty in mouth opening. Various surgical modalities are mentioned for release but each has its own limitations. This article introduces a new technique of release of submucous fibrosis and reconstruction using superficial temporal fascia flap and split skin graft. The surgical technique involves a pre-auricular incision extending into the temporal region with dissection carried out in the sub follicular plane to develop the superficial temporal fascia flap to its maximum extent. The masseter muscle origin is released from the zygomatic arch and the temporalis muscle insertion is released from the coronoid process through an external approach. The entire fibrosed mucosa is released intraorally to create a mucomuscular defect thus achieving full mouth opening. The superficial temporal fascia flap is then brought in and sutured to the intraoral defect, which is then covered with a split thickness skin graft. This procedure is performed bilaterally. A total of five patients were treated with this new technique and all of them showed good mouth opening in long term follow up. There was no donor site morbidity. The incision line is well hidden in the hair bearing area. A well vascularised superficial temporal fascia flap brings in good blood supply to the area of affected muscle and mucosa to improve its function.

Management of concomitant maxillofacial, cervical spine and laryngeal trauma--case reports.

Three cases are presented to stress important points in the diagnosis and management of concomitant maxillofacial, cervical spine and laryngeal trauma. Emergency tracheostomy to control airway, immediate rigid fixation of maxillofacial fractures, early computed tomographic (CT) scans to evaluate the extent of laryngeal and cervical spine injury and the early repair of laryngeal injury will provide better aesthetic and functional results.

Corrosive acid strictures of the stomach (a case report).

Two patients presented with history of suicidal acid ingestion. Both the patients developed strictures exclusively in the stomach without involvement of the oesophagus, after a period of 12 weeks. The mechanism of this involvement is presented. The literature on this subject is briefly reviewed.