Cleft lip and cleft palate repair are surgeries of the lip and the roof of the mouth. These repairs are two separate surgeries that are sometimes done together.
Surgery is usually done at a young age. Cleft lip repairs occurs most often at age 3-6 months. Cleft palate repairs occurs most often at age 9-18 months
Infant With Cleft Lip
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These surgeries are done to repair birth defects called cleft lip and cleft palate. A cleft lip is an open gap in the upper lip. A cleft palate is an open gap in the roof of the mouth. If left untreated, the child can have many complications, such as:
The goals of cleft lip repair are to:
The goal of cleft palate repair is to have the palate area function normally. This includes proper development of the teeth and jaw, as well as speech.
Complications are rare, but no procedure is completely free of risk. If your child is planning to have cleft lip and cleft palate repair, the doctor will review a list of possible complications, which may include:
If your child has other birth defects, this may put him at a higher risk for complications.
Be sure to discuss these risks with the doctor before the surgeries.
Your child will need to have an empty stomach before surgery. Make sure you get specific instructions about when to stop feeding your child.
In the time leading up to the surgeries, the doctor may have your child wear a device called an obturator. The device fits inside the mouth. It may help your child during feedings and help to keep the arch in the lip.
Your child will be treated by a team of specialists. The doctors will:
General anesthesia will be used. It will block any pain and keep your child asleep through the surgeries. It is given by IV.
To repair a cleft lip, an incision will be made on either side of the cleft. The incision will be from the lip to the nostril. Sutures will be used to close the two parts of the lip. If your child has two openings on either side of the lip, an additional surgery will be needed in about a month. Bandages will be placed over the incision area.
During cleft palate repair, incisions will be made on the two sides of the cleft. A special flap technique will be used to move the hard palate in the front of the mouth and the soft palate in the back of the mouth. The muscle fibers in palate will also be moved. Removable or absorbable stitches will be used to close the area.
Your child will be brought into the recovery room. The hospital staff will monitor your child’s vital signs. In some cases, oxygen may be given through the nose.
Anesthesia prevents pain during surgery. Your child will be given medication to relieve pain or soreness during recovery.
The surgeries are usually done in a hospital. For a cleft lip repair, your child may have to stay overnight. A longer stay may be required if an additional cleft repair is planned. If your child is having cleft palate repair, the hospital stay is usually 2-3 days.
The hospital staff will:
When you return home, do the following to help ensure a smooth recovery for your child:
After the surgeries, you will see scars at the upper lip and nose. These scars will fade with time. After the repairs are done, your child will be able to develop and function normally. In some cases, your child may need more surgeries to improve appearance. Surgeries may also be needed to improve breathing problems, jaw alignment, or speech development.
After leaving the hospital, contact the doctor if any of the following occurs:
Call for medical help or go to the emergency room right away if any of the following occurs in your child:
If you think you have an emergency, call for medical help right away.
Centers for Disease Control and Prevention
National Institute of Dental and Craniofacial Research
Birth Defect Research for Children
Cleft lip and cleft palate repair. American Society of Plastic Surgeons website. Available at: http://www.plasticsurgery.org/x7352.xml . Accessed August 21, 2013.
Cleft lip and palate. Kids Health website. Available at: http://kidshealth.org/parent/medical/ears/cleft_lip_palate.html# . Updated January 2011. Accessed August 21, 2013.
Cleft lip and palate. Pediatric Plastic Surgery website. Available at: http://smilesforkids.missouri.edu/common_conditions/clp.php . Accessed August 21, 2013.
Rosen H, Barrios LM, Reinisch JF, Macgill K, Meara JG. Outpatient cleft lip repair. Plast Reconstr Surg. 2003;112(2):381-387.
What to expect: cleft lip surgery. University of Missouri Children’s Hospital, Pediatric Plastic Surgery website. Available at: http://smilesforkids.missouri.edu/for_parents/cl_expectations.php . Accessed August 21, 2013.
Last reviewed September 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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