Fibrous Dysplasia (Benign) Debulking Surgery

This young man first noticed the development of left-sided facial asymmetry when he was a teenager. It progressively got worse and he now has gross facial asymmetry. Imaging studies revealed a diagnosis of monostotic fibrous dysplasia of the left upper jaw, which was confirmed by a biopsy.
Fibrous dysplasia is a benign condition caused by a protein mutation where healthy bone is replaced by fibrous tissue. It is known as monostotic fibrous dysplasia when only one bone is involved and polyostotic fibrous dysplasia when multiple bones are involved.

Treatment planning was explained to the patient and he was scheduled for surgery. A full thickness mucogingival flap was raised and the affected region of the left maxilla was exposed. The fibrous bone was carefully removed by using a chisel and bur. There will be no visible scarring since the lesion was approached intraorally.
The flap was closed with sutures once facial symmetry with the normal right side had been achieved. There was good cosmetic correction of his facial asymmetry at the completion of the surgery.

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