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Cleft Lip Repair

Last updated March 3, 2019

Felsir

Cleft Lip Repair is a surgical procedure to treat a congenital deformity where the upper lip, nose, and palate, are not fused properly. Imaging showing a child who underwent successful Cleft Lip Repair surgery.


Background Information:

What are the other Names for the Procedure?

  • Cleft Lip/Palate Repair
  • Correction of Cleft Deformity of Lip
  • Repair of Cleft Lip

What is Cleft Lip Repair surgical procedure?

Cleft Lip Repair is a surgical procedure to treat a congenital deformity where the upper lip, nose, and palate, are not fused properly.

What part of the Body does the Procedure involve?

A Repair of Cleft Lip procedure involves the upper lip, nose, muscles around the mouth and palate (the upper portion, or roof of the mouth).

Why is the Cleft Lip Repair surgical procedure Performed?

A Cleft Lip Repair procedure is performed for the following reasons:

  • To make the deformity appear as normal as possible
  • To restructure the palate, nose, and lip, so as to aid in the development of normal speech
  • To prevent problems while nursing and feeding the child
  • To avoid problems during teething
  • Repeated ear infection

What are some Alternative Choices for the Procedure?

To repair a cleft lip and palate, this procedure remains the gold standard technique.

What are the Recent Advances in the Procedure?

The recent advances in a Cleft Lip Repair Surgery are technical advancements, which help during extensive cleft lip repair.

What is the Cost of performing the Cleft Lip Repair surgical procedure?

The cost of Cleft Lip Repair procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding Cleft Lip Repair procedure and what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
  • Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.mayoclinic.com/health/cleft-palate/DS00738/DSECTION=treatments-and-drugs (Accessed on 16th July 2012)

Prior to Cleft Lip Repair surgical procedure:

How is the Cleft Lip Repair surgical procedure Performed?

  • Immediately prior to the procedure, the areas where the normal lip, mouth and palate are placed are marked
  • Next, the skin and the underlying tissue around the cleft is cut, repositioned and reconstructed. Bleeding at this point is stopped either by clamping, cautery, or sutures
  • Finally, the skin is placed to the new position and placed firmly with sutures. These sutures are usually removed after 7-10 days

Where is the Procedure Performed?

A Cleft Lip Repair procedure is performed in a hospital. The individual is admitted, undergoes the procedure and discharged, as per the physician’s instruction.

Who Performs the Procedure?

A Cleft Lip Repair surgical procedure is performed either by a plastic surgeon or a head and neck surgeon, along with an anesthesiologist.

How long will the Procedure take?

The procedure may take anywhere between 1-3 hours. This depends on the kind of repair needed and the extent of cleft lip.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the surgical procedure and helps avoid unnecessary complications.

  • Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
  • If you are allergic to any specific medication or food items
  • If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
  • If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
  • If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
  • If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
  • If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
  • A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Local anesthesia may be used; hence, do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
  • Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
  • The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
  • For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines

What is the Consent Process before the Procedure?

A physician will request your consent for the Cleft Lip Repair procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Cleft Lip Repair surgical procedure?

Prior to a Cleft Lip Repair procedure the individual may have routine blood and urine analysis performed. Some other blood tests may be necessary prior to the procedure, which shall be determined by the physician.   

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

  • What is a Cleft Lip Repair procedure?
  • Do I suffer from cleft lip or cleft palate or both?
  • Is this procedure necessary? 
  • What does the procedure involve?
  • How will this procedure help?
  • How soon should I get it done? Is there an emergency?
  • Who are the medical personnel involved in this procedure?
  • Is there any specialist that you may recommend?
  • Where is the procedure performed? 
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • Are there any lifestyle restrictions or modifications required, after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • Is there any medication that needs to be taken for life, after the procedure?
  • How many such procedures have you (the physician) performed?
  • What are the costs involved?

During the Cleft Lip Repair surgical procedure:

What kind of Anesthesia is given, during the Procedure?

During the procedure the individual is administered local anesthesia, either with or without sedation. However, in some cases, general anesthesia may be administered. When general anesthesia is necessary, the procedure is usually performed at a hospital surgery facility.

How much Blood will you lose, during the Procedure?

The amount of blood lost during the procedure depends on the patient, their age, and extent of the skin to be severed and repositioned.

What are the possible Risks and Complications during the Cleft Lip Repair surgical procedure?

The possible risks or complications that may arise during the surgery are as follows:

  • Excessive bleeding
  • Infection
  • Accidental injury to the neighboring tissue or bone
  • Anesthetic complications

What Post-Operative Care is needed at the Healthcare Facility after the Cleft Lip Repair surgical procedure?

At the healthcare facility, generally there is no requirement for any post-procedure care, unless any complications arise. 

After the Cleft Lip Repair surgical procedure:

What are the possible Risks and Complications after the Cleft Lip Repair surgical procedure?

Post Cleft Lip Repair surgical procedure, the following complications may arise:

  • Infection in the surgical wound
  • Continued bleeding
  • Pain
  • Discomfort
  • Need for further procedures

What is the Prognosis after the Surgery?

The prognosis from the surgery is usually excellent.

When do you need to call your Physician?

Do contact your surgeon/physician if you notice any of the following symptoms:

  • Pain around the surgical wound
  • Swelling and redness
  • Bleeding or drainage
  • Constipation
  • Fever
  • Dizziness
  • Muscle ache
  • Nausea or vomiting
  • Signs of infection
  • If any new symptom or discomfort is observed

What Post-Operative Care is needed at Home after the Cleft Lip Repair surgical procedure?

At home, the following post-operative care is recommended, post Cleft Lip Repair surgical procedure:

  • Complete the course of medication and antibiotic, prescribed by the physician
  • Wash the incision site with mild soap, while bathing
  • Resume daily activity only after you feel better
  • Avoid non-prescription medications
  • The individual may have difficulty speaking; hence, the physician may recommend a speech therapist

How long does it normally take to fully recover, from the Procedure?

It takes about 4 weeks to completely recover from the procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The procedure does not involve the surgical removal of any tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Cleft Lip Repair surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility charges and the physician charges. Alternatively, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital
  • The plastic surgeon or the head and neck surgeon
  • An anesthesiologist (if anesthesia was administered)
  • The patient is advised to inquire and confirm the type of billing, before the Cleft Lip Repair procedure is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 1, 2013
Last updated: March 3, 2019