General Considerations of Cleft Lip Surgery
Surgery is performed in the hospital under general anesthesia. In most centers, the child is admitted to the hospital one day before surgery. The surgical 
procedure for closure of a unilateral cleft lip and nose deformity generally requires between one to two hours. The hospital stay is usually twenty-four hours.
After the surgery is completed, the child is taken to the recovery room for careful monitoring. When your child has safely recovered from anesthesia and is waking up, you will be able to be with him or her before returning to the child’s hospital room. During the rest of your child’s stay, you will learn how to care for the operative wound, and you will be taught the special technique of cup feeding.
Your baby will wear arm restraints to keep him or her from touching or disturbing the freshly reconstructed nose and lip. These restraints are for your child’s safety and are not uncomfortable. They should be kept on at all times after surgery for a period of up to three weeks. This will be discussed with you in further detail prior to the operation.
Your child’s lip must be cleansed of any crusted fluid or blood. To prevent any sucking motion which may injure the newly reconstructed lip, you will carefully feed your child with a cup or syringe.
Sutures in the lip are removed at approximately five to seven days after surgery. A dressing of steri-strips is then applied to secure and protect the suture line. You may apply paper tape for several weeks after surgery. Specific instructions regarding this procedure will be given to you at the appropriate time.
It will take two and a half to three weeks for the operative wound to gain sufficient strength to resist damage. During this time, it is important for your child to continue wearing the arm restraints and to be prevented from rolling over.
Surgery Specifics:
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Unilateral Cleft Lip – Surgery
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Unilateral Cleft Nose – Repair
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Bilateral Cleft Lip – Surgery
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Bilateral Cleft Nose – Repair
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Cleft Palate – Surgery
Advances in Repairing a Cleft Palate
In the past, a cleft lip, palate, or combination thereof meant a lifetime of health problems. Children born with one of these congenital deformities often had difficulties with eating, poor weight gain, speech impediments, and ear and nose infections. Advances in today’s medicine have helped to alleviate many, if not all, of the complications from a cleft palate. Children with a cleft lip, palate, or both are now benefiting from surgery that fuses together the muscle and tissue to allow for a normal lifestyle.
Through medical advances, children born with a cleft palate are now often referred to a team or group of specialists at birth. These specialists start with reconstructive surgeons who have extensive training in repairing a cleft lip, palate, or combination of both. To further aid in the health and development of a child born with a cleft palate, the team may also involve speech therapists, an ear, nose and throat specialist, a dentist, and an orthodontist.
Preparing for Cleft Lip and Palate Surgery
Modern technology and the vast improvement in cleft palate surgery have allowed most children born with the deformity to live normal happy lives. However, as with all surgeries, there are some risks. Preparing for surgery on a cleft lip, palate or both can improve the chances of a successful repair. Here are a few things to consider before you child undergoes cleft palate surgery:
- Discuss proper timing for cleft palate surgery. Though children with a cleft lip, palate, or combination thereof may have difficulties with feeding at birth, it is best to wait until the child is nine to eighteen months old. The higher birth weight will make surgery for a cleft palate less risky and easier to perform.
- Find out about the type of anesthesia and the risks to your child. Heavier anesthesia may be needed for a cleft palate as opposed to a cleft lip. Palates may also require more post-operative pain medication.
- Prepare for feeding your child after surgery for a cleft lip, palate or both. Children with cleft palates often have difficulty eating post surgery and may require an IV.
- Prevent irritation of the repaired cleft lip, palate or both. Be aware of the elbow restraints that may need to be utilized in order to keep your child from aggravating the repaired cleft. Palates often require a longer recovery time.
