Cleft Lip/Palate

What is this?

Cleft lip (cheiloschisis) and cleft palate (palatoschisis) are among the most common birth defects affecting children in North America.

The incomplete formation of the upper lip (cleft lip) or roof of the mouth (cleft palate) can occur individually, or both defects may occur together. The conditions can vary in severity and may involve one or both sides of the face.

Procedure

Cleft lip and palate repair is a type of plastic surgery to correct abnormal development both to restore function and to restore a more normal appearance.

Step 1 – Anesthesia

Medications are administered for your child's comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for your child.

Step 2 – The Incision

The goal of cleft lip surgery is to close the separation in the lip and to provide a more normal function, structure and appearance to the upper lip. Incisions are made on either side of the cleft to create flaps of tissue that are then drawn together and stitched to close the cleft.

Step 3   Suturing of the Incision

Cleft lip and palate incisions can be closed with removable or absorbable sutures.

A special note: It is important to understand that while a cleft may be surgically repaired in a single plastic surgery procedure, treating a child born with a cleft continues through adolescence and sometime even adulthood. As a child grows, secondary plastic surgery procedures to improve function and appearance may be required.

Step 4 – Seeing Results

The resulting external scars of a cleft repair are generally positioned in the normal contours of the upper lip and nose. Over time, these will fade and your child's ability to grow and function normally will continue to improve.

 

Recovery

You will be given specific instructions that may include: How to care for the surgical site following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, specific concerns to look for in the general health of your child and when to follow-up with your plastic surgeon.

Your plastic surgeon or the attending staff will instruct you on feeding your child and as well as any restrictions or special activity instructions.

Don't be surprised if you find that arm restraints have been placed on your child in recovery. They will prevent him or her from injuring the surgical site as it heals. Restraints may be removed several times as day, so long as your child is supervised and prevented from touching the surgical site or sucking a thumb.

Your child's discomfort can be controlled with pain medication. If necessary, sutures will be removed following surgery. Healing will continue for several weeks as swelling resolves.  After surgery, diligent sun protection is essential to prevent the formation of irregular scars

Results

The outcome of your child's initial cleft lip and/or cleft palate repair will make a vast difference in his or her quality of life, ability to breathe, eat and speak. However, secondary procedures may be needed for functional reasons or to refine appearance. Even though the scars of a cleft lip repair are generally located within the normal contours of the face, they will always be visible.