The right and left edges of the lip and the palate form together, long before birth, in the first few weeks of development. However, normal fusion does not take place in approximately one in every 1000 babies. Since the lip and palate develop separately, a number of variations in cleft lip and palate can be seen. Major progress has been made in treating children born with cleft lip or palate, and there is no obstacle to the majority living healthy and happy lives.
If surgical repair of cleft lip and palate is carried out by an experienced plastic surgeon, very good results can be achieved. However, as with all operations, various risks and complications can be encountered. The most common problem after cleft lip repair is imperfect symmetry on the two sides of the lip. The basic aim in lip repair is to close the cleft in a single operation, but a secondary operation may from time to time be necessary. The basic objective in cleft palate surgery, on the other hand, is to allow the child to eat and speak normally by sealing the cleft. Occasional healing problems and speech defects may again necessitate a second procedure.
Cleft Lip Surgery
Cleft lip may assume a variety of forms, from a small notch in the upper lip to a full cleft stretching to the bottom of the nose. The cleft may be on one or both sides of the lip. Surgery is generally performed when the child is 6-10 weeks old. Muscle repair is performed following the incision made on either side of the cleft. The cleft will be covered up with repair of the skin and mucosa. Muscle function will thus be acquired and a normal lip shape established. Deformities in the nose will also benefit from this procedure.
HEALING AFTER CLEFT LIP SURGERY
Your child may experience a distressed period after surgery. In order to keep your child’s hands away from the surgical area it will be necessary for a time to use bandages that prevent bending of the elbows. Skin sutures will be removed after five days, or else will disappear spontaneously, depending on the material employed. Your doctor will give you advice on feeding your child for the first few weeks. The operation scar will be redder and broader for the first few weeks. This will gradually recede, though the scar will never disappear entirely. But this scar becomes practically unnoticeable in many children due to the shading in the lip region.
Cleft Palate Surgery
Palate clefts may be minor notches affecting the uvula in some children, while in other they extend as far as the lip region. Cleft palate repair can be performed between 3 and 12 months, depending on the surgeon, the anesthetists and the condition of the patient. This makes it easier for the child to tolerate the surgical procedure. During the surgical procedure, the tissue on the edges of the cleft are brought together toward the central line with incisions along the two sides and integrity of the palate thus established. Soft palate muscles are also repaired during this procedure, thus enabling the child to speak properly and providing the foundation needed for eating.
Healing after Cleft Palate Surgery
Distress and pain can occur in the first day or two after surgery, though these can easily be controlled with drugs. Although the child begins feeding by mouth during this period, since he or she is not able to consume as much as normal, the requisite support is provided by administering fluid intravenously. Bandages that prevent the child bending its elbows will be necessary for the first few days in order to avoid contact between hands and mouth. Your doctor will give you advice on feeding your child over the first few weeks after surgery. It is essential to follow that advice in order for the palate to heal without problems.