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Elledge Surgical Limited

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Elledge Surgical Limited

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A private Maxillofacial service in the West Midlands focused on and 🩺

30/10/2026

“What happens if the roots break during a wisdom tooth extraction??” 😳🦷

First things first… it’s not necessarily the disaster you might think it is!

Root fractures during tooth extractions are not uncommon, and they certainly don’t automatically mean something has gone wrong.

Some teeth have particularly thin, curved or delicate roots… and when those roots are firmly surrounded by dense jawbone, they can occasionally fracture during removal.

In fact, I’m regularly referred patients whose dentists have encountered fractured roots during an extraction and would prefer a specialist to remove the remaining fragments.

So, what happens next? 👇

Well, it depends on the size and position of the fragment.

🦷 Sometimes it’s relatively straightforward. If enough of the root remains accessible, we may be able to retrieve it using specialist instruments.

🦷 Sometimes a surgical extraction is needed. This involves carefully exposing the area and removing a small amount of surrounding bone to create access to the remaining root.

🦷 And sometimes the safest decision is actually NOT to remove it.

Yes, really!

One of the most important considerations is what’s sitting around those roots.

In the lower jaw, we need to be particularly mindful of the nerves responsible for sensation in the lower lip and chin. In the upper jaw, we’re often working very close to the maxillary sinuses.

The last thing we want is to cause more harm while trying to retrieve a tiny fragment of tooth.

Very occasionally, if a root fragment is particularly small, unlikely to cause problems and positioned close to an important anatomical structure, the risks of removing it may outweigh the benefits.

In those circumstances, leaving it in place can sometimes be the most appropriate option, provided it is carefully assessed and monitored where necessary.

But this is very much the exception rather than the rule.

And if it’s something I’m considering, it’s always an open and honest discussion with my patient, so we can make an informed decision together.

💬 Have you ever been told that a tooth root broke during your extraction?
🌐 elledgesurgical.com

27/10/2026

You’ve had a skin cancer removed from your nose. But what happens to the wound that’s left behind? 👃🤔

It’s one of the most common concerns patients have when facing Mohs surgery, and understandably so.

➡️ “What will my nose look like afterwards?”

The nose is one of the most visible and anatomically complex areas of the face. And when skin cancer needs to be removed, careful reconstruction can be just as important as the cancer removal itself.

As a Consultant Oral and Maxillofacial Surgeon, facial skin cancer reconstruction is an important part of my work.

I regularly collaborate with specialist dermatologists who perform Mohs surgery, helping to reconstruct the wound once the cancer has been successfully removed.

But did you know there are several different ways we can reconstruct the nose?

▪️ Direct closure - For suitable wounds, we may be able to bring the skin edges together using stitches

▪️ Skin grafts - Skin is taken from another area of the body & transferred to cover the wound, where it establishes a new blood supply

▪️ Local skin flaps - Nearby tissue is carefully moved into the wound while maintaining its blood supply. This can be particularly useful when matching the surrounding skin’s colour & thickness

▪️ Forehead flaps - For certain more complex nasal defects, we can use skin from the forehead to reconstruct the nose. This usually involves staged surgery & can achieve reconstruction where simpler techniques may not be suitable

For me, successful facial reconstruction is about far more than simply closing a wound 🙏

We need to consider the shape and structure of the nose, the surrounding tissues, the position of the nostrils, the potential impact on function and, of course, the eventual appearance of the scar.

➡️ Not every patient will need a graft or flap, & there is no single technique that’s right for everyone.

The priority is always to select the most appropriate reconstruction for the individual 🙏

25/10/2026

Patient feedback like this means so much to me 🙏

⭐️⭐️⭐️⭐️⭐️

“The whole experience was professional, friendly and I felt well looked after by the hospital staff.

Mr Elledge was very kind, friendly and reassuring in the operating theatre, thus making the surgery not at all scary and I felt to be in good hands. I would thoroughly recommend him.”

- Verified patient review, via TopDoctors

For many patients, the thought of surgery can feel daunting - and that’s completely understandable 👨🏻‍⚕️

Whether it’s oral surgery, TMJ surgery, skin cancer surgery or another maxillofacial procedure; feeling informed, reassured and well looked after is such an important part of the experience.

As a surgeon, technical skill and careful planning are essential - but so is the human side of care: taking time to explain, reassure and help patients feel safe at every stage.

Thank you to this lovely patient for taking the time to share such kind words. It is a privilege to be trusted with your care 🙏

17/10/2026

Could botulinum toxin be the answer to your jaw pain? 👀💉

When most people hear the words botulinum toxin, they immediately think of anti-wrinkle injections. But did you know it can also have an important role in managing certain types of facial pain, jaw tension & temporomandibular disorders?

As an Oral and Maxillofacial Surgeon specialising in TMJ disorders & facial pain, I regularly see patients experiencing symptoms such as:

🔹 Persistent jaw pain or facial aching 🔹 Tightness & tension around the jaw 🔹 Teeth clenching & grinding 🔹 Pain or discomfort when chewing 🔹 Headaches & tenderness around the temples

And while these symptoms can be incredibly frustrating to live with, the first thing we need to understand is what’s ACTUALLY causing them

➡️ Because not all jaw pain comes from the jaw joint itself

In some patients, the problem lies predominantly within the surrounding muscles, particularly the masseter and temporalis muscles, which can become overactive, tense & painful

➡️ This is where botulinum toxin may be useful

By carefully injecting botulinum toxin into selected muscles, we can temporarily reduce excessive muscle activity; helping relieve tension & potentially improve muscle-related facial pain

➡️ But here’s the important part…

Botulinum toxin ISN’T a universal solution for TMJ pain, and it certainly ISN’T appropriate for everyone

If your symptoms are caused by an issue within the joint itself, relaxing the surrounding muscles may NOT address the underlying problem. And even where muscular tension is involved, we would usually consider more conservative approaches first; including exercises, medication & appropriate dental appliances

➡️ The key is getting the diagnosis right BEFORE deciding on treatment

In my practice, I see patients with a wide range of jaw joint & facial pain conditions, & my approach is always to understand the underlying cause rather than simply treating the symptoms

✅ Sometimes, botulinum toxin can be an effective part of that plan
❌ Sometimes, a completely different approach is needed

Because when it comes to facial pain, one size most definitely DOESN’T fit all

15/10/2026

BCC vs SCC: Two common types of skin cancer, but two very different patterns of behaviour ⬇️

You may have heard of Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC), but do you know what they are, how they differ & why we approach their treatment differently?

Both are forms of skin cancer that develop from cells within the epidermis - the outermost layer of the skin. However, there are some important differences between them ⬇️

🔬 BASAL CELL CARCINOMA (BCC)

BCC is the most common type of skin cancer. It typically grows slowly & tends to remain localised to the area where it first develops

Historically, BCCs were sometimes referred to as ‘rodent ulcers’ because, if left untreated, they can gradually grow deeper into the surrounding tissues. Importantly, BCCs very rarely spread to other parts of the body

⚠️ SQUAMOUS CELL CARCINOMA (SCC)

SCCs behave a little differently

While they can also grow locally and damage surrounding tissues, SCCs have a greater potential to spread beyond their original location

This can include nearby lymph nodes, such as those in the neck when we’re dealing with skin cancers of the head and face, and, in more advanced cases, distant organs

Some SCCs can also grow & change relatively quickly, which is why they may require more urgent assessment and treatment

WHY DOES THE DIFFERENCE MATTER? ⬇️

Because understanding the type of skin cancer we’re dealing with helps determine how urgently it needs to be treated, the most appropriate surgical approach & whether any further investigations are necessary

Although BCCs generally grow more slowly, both types of skin cancer should be assessed & treated appropriately

And when operating on the face, particularly around delicate areas such as the eyelids, nose, lips & ears, surgical planning is especially important

The aim is always to remove the cancer effectively while preserving as much healthy tissue, function & natural facial appearance as possible

➡️ Have you noticed a new, changing or non-healing lesion on your skin?

Don’t ignore it. Arrange assessment with an appropriate healthcare professional. Early diagnosis & treatment can make a s

13/10/2026

Sometimes, the most important part of surgical planning is thinking about where the scar will sit afterwards 🙏

A lovely patient case, reviewing her healing progress just six weeks after the surgical removal of a sebaceous cyst.

And a great example of how careful incision placement can make a real difference to the final appearance of a surgical scar.

In this case, I was able to position the incision within the nasolabial fold - the natural crease running between the nose and the corner of the mouth.

Why does that matter? ⬇️

Because whenever we’re performing surgery on the face, we’re thinking about much more than simply removing the lesion.

We’re also considering:

🔹 The surrounding facial anatomy
🔹 Natural skin creases and contours
🔹 Incision placement and wound closure
🔹 Minimising unnecessary tension on the skin
🔹 How the resulting scar is likely to settle over time

The aim is always to remove the lesion safely while achieving the best possible functional and aesthetic outcome 🙏

At just six weeks post-op, this scar is already sitting neatly within this patient’s natural facial crease, helping it blend into the surrounding anatomy.

➡️ And importantly, scar maturation continues for many months following surgery.

A relatively straightforward procedure, but a lovely reminder that attention to detail matters - even in the smallest operations.

Definitely one for the case album! 👏

10/10/2026

That mouth ulcer you’ve been ignoring? It might be time to get it checked… 🔍

Mouth ulcers and white patches are incredibly common, and in many cases, they’re nothing to be seriously concerned about.

But as an Oral and Maxillofacial Surgeon, one thing I always encourage patients to understand is that not every change inside the mouth should be dismissed as harmless 🙏

So, what should you look out for?

🔹 Mouth ulcers - Often caused by minor trauma, irritation or other benign conditions. However, an ulcer that hasn’t healed within three weeks should always be assessed.
🔹 White patches - These can have several causes, including oral thrush, lichen planus and leukoplakia. Some white patches, particularly those that cannot be rubbed away, require further investigation.
🔹 Red or mixed red-and-white patches - Changes in the appearance of the oral lining that persist without an obvious explanation should also be examined.
🔹 Unexplained lumps, thickening or persistent soreness - Particularly when symptoms aren’t improving or are becoming more noticeable.

Now, does finding a white patch or persistent ulcer mean you have oral cancer?

➡️ Absolutely not.

But certain changes can occasionally represent potentially precancerous conditions or, less commonly, an early sign of oral cancer.

And that’s precisely why an accurate diagnosis matters 🙏

In my practice, assessing oral lesions begins with a thorough examination and understanding the patient’s history.

Sometimes reassurance or straightforward treatment is all that’s needed.

Other times, we may recommend further investigation, including a biopsy, to establish exactly what’s happening.

➡️ The important thing is not to ignore something simply because it isn’t painful.

If you have a mouth ulcer that hasn’t healed after three weeks, a persistent white or red patch, or another unexplained change in your mouth, arrange an assessment with your dentist or GP.

Most oral changes are not cancer. But knowing when to investigate can make all the difference 🙏

Have you ever noticed a white patch or recurring ulcer and wondered whether it was something to worry about? 💬

Find out more: elledgesurgical.com

08/10/2026

Removing a skin cancer is only one part of the story. Reconstructing what remains matters too 🙏

When we talk about skin cancer surgery, understandably, the first priority is removing the cancer completely.

➡️ But particularly when a skin cancer occurs on the face, there is another important part of the process: what happens afterwards?

I regularly work alongside dermatology colleagues who perform Mohs surgery, a technique that allows the cancer to be removed while the margins are carefully checked to ensure no cancerous cells remain.

Once we know the cancer has been successfully removed, my reconstructive work begins.

➡️ And this is about far more than simply “closing the hole”

The face is complex. We have eyelids that need to open and close, lips that need to move, noses that need to maintain their shape and function, and countless important nerves, muscles and anatomical structures within a relatively small area.

Depending on the size and location of the defect, reconstruction might involve:

→ Directly closing the wound → Repositioning nearby skin using a local flap → Using a skin graft → Or planning a more complex reconstruction

The approach is different for every patient and every part of the face 🙏

➡️ The priority is always complete cancer removal first.

Then, reconstruction is about restoring the area as thoughtfully as possible - respecting function, anatomy and appearance while helping the patient move forward from their skin cancer treatment.

Removing the cancer is only one part of the story ⬇️

What we do next matters too 🙏

04/10/2026

Jaw pain doesn’t always come from the same place - and understanding the anatomy can give us important clues as to what may be causing it 🙏

The temporomandibular joint (TMJ) is a complex structure where the condylar head of the mandible sits within the mandibular (glenoid) fossa at the base of the skull 💀 Between the two is an articular disc, which acts a little like a shock absorber as the joint moves 💢

Around the joint are the muscles that help us chew and move the jaw, including the masseter - the large muscle running down the side of the jaw - and the temporalis, the broad, fan-shaped muscle across the side of the head.

➡️ So where does the pain actually come from?

💀 Inside the joint: inflammation, problems with disc movement or irritation of the tissues behind the disc, which contain a rich supply of nerves and blood vessels.
🦴 Arthritis: degeneration of the joint surfaces can cause pain, stiffness and restricted movement.
💢 The muscles: clenching and grinding can overload the chewing muscles, particularly the masseter and temporalis, leading to muscular pain and tension.

➡️ And the location and pattern of the pain can be an important clinical clue.

Someone with pain originating within the joint may point directly to the area in front of the ear and say, “That’s where it hurts.”

Someone with muscular pain may describe headaches at the temple and pain extending down the side of the jaw, giving a much broader pattern.

Understanding the anatomy helps us understand the possible source of the pain - and, importantly, where we need to look and what may be appropriate to treat 🙏

If you have persistent jaw pain, clicking, locking, headaches or difficulty opening your mouth, an accurate assessment is the first step.

➡️ Get in touch to find out more: elledgesurgical.com

02/10/2026

Your jaw is a joint - and like any other joint, it can develop arthritis 💢

The temporomandibular joint (TMJ) is one of the most frequently used joints in the body, performing thousands of movements every day as we eat, speak and swallow. So, over a lifetime, it is perhaps unsurprising that it can experience wear and tear and, in some patients, progress to osteoarthritis.

TMJ arthritis can have a significant impact on everyday life. Pain, stiffness and restricted mouth opening can make eating and speaking difficult, while reduced function can ultimately affect nutrition and overall quality of life.

➡️ The good news is that most patients with TMJ arthritis will not require surgery. For those who do, treatment can often be minimally invasive, such as keyhole surgery (arthroscopy).

However, in a small number of patients with end-stage TMJ disease, more extensive surgery may be required.

I provide open TMJ arthroplasty and total alloplastic joint replacement for patients with advanced TMJ disease, and I am currently the only private provider in the West Midlands offering these procedures 👨🏻‍⚕️🩻🥼

If you’re experiencing persistent jaw pain, restricted mouth opening or difficulty eating, and these symptoms are affecting your quality of life, specialist assessment can help establish what is happening and what treatment options may be appropriate.

Let’s get things moving again 🙏

Address

The Lewis Building, 35 Bull Street
Birmingham
B46EQ

Opening Hours

Monday	9am - 5pm
Tuesday	9am - 5pm
Wednesday	9am - 5pm
Thursday	9am - 5pm
Friday	9am - 5pm

Telephone

+442033263827

Website

http://elledgesurgical.com/enquiries

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