What kind of surgery or reconstruction procedure(s) will be needed to repair Cleft Lip/Cleft Palate in baby, and when will they occur?

Children with cleft lip and/or palate deformities often undergo a series of operations within the first two years of life. This usually first includes a lip repair (possibly with a nasal correction at the same time) at around three months of age. The surgery can be delayed if the child is born prematurely or is of slight stature. The child should be at least ten weeks old, weigh 10 pounds, and have a hemoglobin (measurement of the blood count) level of 10 before undergoing this surgery.

The palate is then repaired between six to twelve months of age depending on the surgeon. Many surgeons repair the palate in one stage at or near twelve months of age to promote good speech.

Each surgeon should have a protocol that works for him or her and is specific to each center. It is recommended that you seek a surgeon associated with a respected and affiliated center so that the child can receive complete care from team of specialists, including a speech pathologist, pediatric dentist, geneticist, pediatric anesthesiologist, and pediatric ear, nose, and throat specialist. These people will be closely integrated into the child’s care.

After the first year, there can be additional operations depending on the severity of the cleft and the resulting facial changes during growth. Many issues present themselves over time as the child grows. The face often becomes asymmetric and deficient on the cleft side. Operations can include a bone graft into the cleft at the level of the gum line, a nasal procedure to improve breathing and straighten the nose, and even jaw surgery to improve the bite and facial balance. Further surgeries are performed on an individual basis. The goal is to keep the child’s facial features as symmetric and functional as possible throughout growth.