Cleft Lip and Palate Repair

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.

A cleft, or separation of the upper lip and/or the roof of the mouth, occurs very early in the development of your unborn child. During fetal development, certain components of the upper lip and roof of the mouth fail to form normally.

Board certified plastic surgeons Dr. Derby and Dr. Buchanan can repair most clefts through specialized plastic surgery techniques, improving your child’s ability to eat, speak, hear and breathe, and to restore a more normal appearance and function.

Cleft lip repair, also called cheiloplasty, at Spokane Plastic Surgeons includes reconstruction of a more normal appearance, namely:

  • Closure of the cleft resulting in a scar located in the normal structures of the upper lip
  • Formation of a cupid’s bow (the curve at the center of the upper lip)
  • Considerations for adequate distance between the upper lip and nose

cleft lip repair and reconstruction

Repairing a Cleft Lip and Cleft Palate

Cleft 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.
Cleft Palate - Incisions are made on either side of the cleft and specialized flap techniques are used to reposition muscle and the hard and soft components of the palate. The repair is then stitched closed, generally at the midline of the roof of the mouth, providing enough length of the palate to allow for normal feeding and speech development, and continued growth throughout life.
Image courtesy of American Society of Plastic Surgeons


Important Considerations

Because the palate creates the floor of the nasal cavity, important considerations in repairing a cleft palate include:

  • Allowing for normal growth, function and speech development
  • Relation of the palate to the auditory canal and hearing
  • Development of the teeth and jaw alignment

Additional Procedures May Be Needed

Where the cleft also affects the shape of the nose, additional procedures may be recommended to:

  • Achieve symmetry between the nostrils
  • Create adequate length of the columella (the tissue that separates the nostrils)
  • Increase the angle of the nasal tip, to avoid a flattened nasal tip or one that pulls downward

When Should Your Child Have the Surgery?

The timing of the cleft repairs depends on the individual circumstances of your child. Cleft lip repairs are initially performed when a child is at least 10 weeks of age and 10 pounds in weight and has a hemoglobin (or blood count) of at least 10. Cleft palate repairs are generally performed when a child is somewhat older, from 9 to 18 months of age. Cleft repair may be delayed in order to treat other, more life-threatening problems that may be present, such as a heart or lung disorder.

Cleft Lip and Palate Reconstruction 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.

After surgery, diligent sun protection is essential to prevent the formation of irregular scars. Even though the scars of a cleft lip repair are generally located within the normal contours of the face, they will always be visible.

Contact us today for more information about cleft lip and palate repair surgery.

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