PROCEDURES



Cleft lip/palate repair

An infant may be born with a cleft lip and/or palate. With a cleft palate, there is a noticeable gap in the roof of the mouth which should separate the mouth from the nose. A cleft lip is a split on one or both sides of the baby's lip. A cleft lip can be partial where there's only a slight split on the lip, or it can be a complete cleft lip where the division runs from the baby's upper gum into his or her nostril.

Usually, when the baby is about 3-4 months old, the plastic surgeon performs surgery to repair the cleft lip. A cleft palate is usually repaired between 9 to 12 months of age. A cleft palate affects feeding as well as the baby’s growth and speech development, for this reason, infants with a cleft palate usually require care from a multi-disciplinary team comprising of a plastic surgeon, speech therapist, ear nose and throat surgeon, and maxillofacial specialist.

Fast Facts:

Length of procedure: Cleft lip repair takes 1 – 2 hours. Cleft palate repair takes 1 – 2 hours.
Type of anaesthesia: General anaesthetic (child is asleep and pain-free).
Length of stay: 1 - 2 nights
What to expect post-op: Some swelling, discomfort, bleeding from the sutures. The cleft lip repair may appear or feel 'tight' immediately after surgery. In the case of palate repair surgery, there may be some temporary difficulty swallowing.
Recovery time: Children recover quickly and are usually fine by day 2 after the surgery. Avoid rough play and keep them from touching the sutures. After cleft palate repair, a diet of soft foods is initiated for the first week.
Results: Results of the lip closure are visible immediately, but the scar will take a few months to improve. Results of Cleft palate repair are evident at a week, but speech development or improvement depends on follow-up with intensive speech therapy.

What does a Cleft lip/palate repair involve?

During your consultation, Dr do Vale will discuss and answer the questions you may have regarding cleft lip/palate, all options available to help your child, the risks involved, post-operative management and therapy, and the expected results.

The surgery performed to correct a cleft lip is called a cheiloplasty. Cleft lip repair surgery repairs the baby's cleft and improves the function, symmetry and appearance of the infant's lip and nose. In a case where the baby's cleft lip is extensive, the plastic surgeon may initiate pre-surgical therapy to narrow the cleft. This may include naso-alveolar moulding with a plate, taping of the lip or lip adhesion. After cleft lip surgery, there's a scar left beneath the baby's nose, but it is placed along the philtrum column and is fairly inconspicuous.

To correct a cleft palate, the plastic surgeon performs a procedure called a palatoplasty. This is done when the baby is about nine to twelve months old. The plastic surgeon performs a palatoplasty to close the ‘hole’ in the palate between the infant’s nose and mouth to improve speech development and prevent food from seeping out the nose. Cleft palate repair often requires staged procedures to seal the cleft in sections. The most important stage of palate repair surgery is when the plastic surgeon realigns and corrects soft palate muscles (at the back of the palate) to promote speech development- this is usually done as the first stage.

Recovery after Cleft lip/palate surgery

Dr do Vale prescribes medication to alleviate pain and prevent infection. It is important to protect the cleft palate repair in the early post-operative period; therefore, Dr do Vale will give special instructions regarding what the child can eat and drink during the recovery phase. After cleft palate repair, a diet of soft foods is initiated for the first week. Children recover quickly and are usually fine by day 2 after the cleft palate surgery. Avoid rough play and keep them from touching the sutures.

After the procedure, there may be some swelling, discomfort and bleeding from the sutures. The cleft lip repair may appear or feel 'tight' immediately after surgery. In the case of palate repair surgery, there may be difficulty swallowing. Any surgery comes with risks, and cleft lip/palate repair is no different. Risks of cleft palate surgery include bleeding, infection, respiratory complications and wound breakdown. Dr do Vale will discuss these risks at your pre-operative consultation.

Results

Results of the lip closure are visible immediately, but lip scars will begin to fade and improve a few months after cleft lip repair surgery. Results of cleft palate repair are evident at a week, but adequate speech development or improvement depends on follow-up with intensive speech therapy.

Cleft lip and palate surgery improve the child's quality of life and enhance speech development. Secondary cleft lip/palate surgeries may be necessary in some cases for functional or aesthetic purposes.

For more information on cleft lip/palate surgery, request a consultation below or call 0109003999 to schedule your detailed consultation with Dr do Vale.

 
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