The surgery takes place in a hospital, under general anesthesia, so the baby won’t be awake or feel any pain. The surgery takes two to three hours, and most babies can go home after one to three days in the hospital, depending on what’s being repaired. Most of the stitches will dissolve on their own and won’t have to be removed later.
Several different surgical techniques are used to repair and reconstruct the lip and palate. The precise surgical plan will vary from patient to patient.
Cleft lip repair
The surgeon will repair a baby’s cleft lip first with a surgery called cheiloplasty, usually when they’re at 4 to 6 months of age. The goals of the surgery are to close the cleft and restore normal anatomy and function of the lip as well as to improve the shape and symmetry of the upper lip and nose.Â
During the procedure, the plastic surgeon will make incisions on both sides of the cleft, to create flaps of skin, muscle, and oral tissue. It’s rare for tissue to be needed from elsewhere on the body to close a cleft. The flaps are then drawn together and stitched, closing the cleft. If the cleft lip is wide, special techniques may be used to help bring parts of the lip closer together. If needed, the shape of the nose can also be addressed at the same time.Â
Cleft lip repair usually leaves a small scar under the nose.
Cleft palate repair
Cleft palate repair is usually done when the child is older (between 9 months and 1 year old), to allow the palate to change as the baby grows.Â
The surgery, called palatoplasty, is performed to close the opening between the nose and the mouth. The repair is done in layers, to create a normal palate. The plastic surgeon will make incisions on either side of the cleft and move tissue on both sides of it, then attach them to each other. This closes the opening to the nose. The muscles of the soft palate (the back of the palate) are rearranged and repaired so they work better during speech. The repair is then stitched closed along the midline of the roof of the mouth.
