A cleft lip is a gap in the upper lip that develops when the tissues forming the lip do not completely join during pregnancy. The condition is present at birth and is not caused by anything a parent did or did not do during pregnancy.
A cleft may affect one side of the lip, known as a unilateral cleft, or both sides, known as a bilateral cleft. Its extent varies from one child to another.
Some children have an isolated cleft lip, while others have both a cleft lip and a cleft palate. A cleft palate is an opening in the roof of the mouth and is a separate condition that may require its own treatment plan.
A clinical assessment helps establish the extent of the cleft and determine which treatments and specialist assessments may be needed.
Cleft lip repair surgery, also called cheiloplasty, is a reconstructive procedure that closes the opening in the upper lip and restores the alignment of the lip tissues and muscles as far as possible.
The goals of surgery generally include:
The precise surgical approach depends on the type and severity of the cleft. The surgeon plans the repair according to the child’s anatomy and overall health.
Although surgery can make a meaningful difference, the final appearance and function vary between children. Some may need additional treatment as they grow.
Understanding the type of cleft helps the surgeon plan treatment.
A unilateral cleft affects one side of the upper lip. Depending on its extent, the opening may involve the lip alone or extend towards the nose.
A bilateral cleft affects both sides of the upper lip. The anatomy can be more complex, and surgical planning is tailored to the child’s individual needs.
An incomplete cleft does not extend through the full height of the upper lip, while a complete cleft extends towards the nose. The exact anatomy varies, and some children also have an associated cleft palate.
The type of cleft, the position of the surrounding tissues and any associated conditions help determine the treatment plan.
Cleft lip repair is commonly performed during the first six months of life in infants who are medically ready for surgery. The exact timing depends on the child’s general health, growth, nutritional status, cleft anatomy and the assessment of the treating team.
Before surgery, the medical team may review the baby’s feeding, weight gain, breathing, medical history and suitability for anesthesia. Additional assessments may be needed if the child has other health conditions.
Parents should not use a general age guideline as a substitute for an individual assessment. The treating surgeon and pediatric anesthesia team will advise when surgery is appropriate for the child.
The procedure is planned according to the type of cleft and the structures involved.
The surgeon examines the lip and nose, reviews the child’s medical history and assesses general health and growth. Parents can discuss the surgical plan, expected results, possible complications and postoperative care.
If the child has an associated cleft palate or other medical needs, additional assessments or referrals may be recommended.
Cleft lip repair in infants is generally performed under general anesthesia. The pediatric anesthesia team assesses the child and explains the preparation, monitoring and recovery arrangements.
Parents receive instructions about feeding before surgery, medications and when to arrive at the hospital.
Cleft lip repair in infants is generally performed under general anesthesia. The pediatric anesthesia team assesses the child and explains the preparation, monitoring and recovery arrangements.
Parents receive instructions about feeding before surgery, medications and when to arrive at the hospital.
After surgery, the child is monitored as they recover from anesthesia. The medical team advises parents about feeding, pain management, wound care and follow-up appointments.
The length of hospital observation depends on the child’s condition, the procedure and the treating team’s protocol.
Recovery varies between children. Swelling, bruising and tenderness may occur after surgery, and the incision requires careful attention while it heals.
Parents receive specific instructions about feeding and hydration. The recommended feeding method may depend on the child’s age, the surgical repair and the treating team’s protocol.
Follow the instructions provided by the surgical team rather than changing feeding methods independently. Contact the care team if the child is feeding poorly, has fewer wet nappies than usual or shows signs of dehydration.
Follow the surgeon’s instructions for keeping the incision clean and protecting it during healing. Do not apply creams, ointments or home remedies unless they have been recommended by the treating team.
Attend follow-up appointments so that the wound and the child’s recovery can be assessed.
Contact the treating team promptly if the child develops fever, increasing redness, unusual discharge, worsening swelling, persistent bleeding or concerns about wound healing.
Seek urgent medical attention if the child has difficulty breathing, becomes unusually difficult to wake or shows other serious symptoms.
