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Plastic Surgery Clinic of Chicago

Cleft Lip and Palate
How Are Facial Differences Surgically Treated?

 

Cleft Lip and Palate Chicago

The incomplete formation of the upper lip at birth is referred to as a cleft lip. The same defect in the roof of the mouth is known as a cleft palate, and these two craniofacial malformations are among the most common in the United States. They can occur completely or incompletely, as well as together or individually, which makes the conditions vary in severity.

A cleft lip or palate is more than just an aesthetic facial difference; they can impair a child’s ability to speak, eat, and breathe. The Plastic Surgery Clinic of Chicago has experience in hundreds of procedures to repair facial clefts. We recognize that each case is highly individualized, and that the functional aspects of this procedure are just as important as the aesthetic.

Cleft Lip and Palate

CANDIDATES FOR CLEFT LIP AND PALATE REPAIR

Cleft lips and palates are evident upon birth, and the best time to perform the procedure to correct them is usually during the first year of life. Cleft lip repairs are often carried out when the child is at least three to four months old; cleft palates are typically repaired later, between nine and twelve months of age. It is important to discuss treatment options early with both your pediatrician and plastic surgeon, since a cleft may affect the development of other areas, like the nose, teeth, and face.

Children that have particularly wide or large clefts may be candidates for NAM, or nasoalveolar molding, which is a nonsurgical, minimally invasive approach to reshaping the lips, gums, and nose prior to cleft lip and palate surgery. The NAM technique uses a plastic-like plate to reduce the cleft before the initial cleft lip repair, often resulting in fewer overall procedures your child may need over the course of their development. Be sure to speak with your plastic surgeon to see if NAM may be an option prior to cleft lip and palate surgery.

WHAT TO EXPECT FROM YOUR CONSULTATION

The first step on the path along your child’s treatment plan is a consultation with a board-certified plastic surgeon that has additional training in craniofacial surgery. During this initial consultation, be prepared to discuss treatment options, an extensive overview of the procedures involved, potential complications, and the recovery process.

When you schedule a consultation with the Plastic Surgery Clinic of Chicago, you will speak with a board-certified plastic surgeon that specializes in craniofacial surgery, and will take the time to explain every aspect of a treatment plan to each patient or parent.

HOW CLEFT LIP AND PALATE REPAIR IS PERFORMED

The objective of a cleft lip repair is to close the separation in the lip in such a way that provides function and improves appearance. At the time of the cleft lip repair, surgery is also performed on the nose in order to improve the overall facial symmetry of your child. If there is a cleft in the gum as well, we will repair that if the cleft width is of minimal size (2 mm). Repairing the hole in the gum allows the development and growth of teeth through the cleft.

In a cleft palate surgery, the muscle and tissues are repositioned to close the hole in the roof of the mouth. The uvula, or the “punching bag” in the back of the throat, is also repaired during the cleft palate surgery.

All surgical procedures by the Plastic Surgery Clinic of Chicago are performed at top hospitals in Chicago and CMS or AAAASF-certified surgical centers for safety. The procedure begins with general anesthesia; the corrections made depend on the location and severity of the cleft(s).

In a cleft lip surgery, the plastic surgeon will make incisions on either side of the affected area to create flaps of tissue, which are then mobilized, repositioned, and gently pulled together to close the cleft. These flaps are stitched with both absorbable and non-absorbable sutures that require removal. A reconstruction of the nasal defect and gums are also performed at the time of the cleft lip repair.

Cleft palate surgery requires specialized techniques to reposition the tissue of both the soft and hard parts of the roof of the mouth. The muscles and soft tissue of the roof of the mouth are closed carefully and in such a way that allows normal eating, breathing, and speech development.

RECOVERY AFTER CLEFT LIP AND PALATE REPAIR

After surgery, antibiotic ointment is usually applied to the surgical site, and medications will be prescribed to alleviate pain. It is essential to follow all post-operative care instructions from your surgeon, including specialized feeding or restrictions on physical activity.

Swelling and discomfort are common after cleft lip or palate surgery. It will take several weeks to heal completely, after which swelling will wane and disappear completely.

While the results of a cleft lip and palate surgery are immediately noticeable, it may be necessary to perform secondary procedures as the patient develops, to improve both function and appearance.

POTENTIAL RISKS ASSOCIATED WITH CLEFT LIP AND PALATE REPAIR

Always discuss potential risks with your plastic surgeon before deciding to have any surgical procedure performed. The possible complications associated with cleft lip and palate repair include:

  • Bleeding
  • Infection
  • Irregular or asymmetrical scars
  • Possibility of secondary surgeries
  • Speech difficulties

Always make sure that the surgeon performing the procedure is board-certified by the American Board of Plastic Surgery with subspecialty training in craniofacial surgery, and that the surgery is being carried out in an accredited surgical facility.

WHAT DOES CLEFT LIP AND PALATE REPAIR COST?

Most health insurance plans will cover a majority, or even the entirety, of a cleft repair procedure because it is considered reconstructive in nature. Health coverage varies, so please contact your health insurance provider before scheduling a consultation.

SCHEDULE A CONSULTATION

The decision to undergo a surgical procedure is never a simple one, and it involves a great deal of trust—especially when the patient is your child. The Plastic Surgery Clinic of Chicago has more than just experience in the traditional hospital setting; our plastic surgeons have served on international missions to help children with cleft lips and palates in other countries, performing life-changing procedures for those who otherwise lack access to modern healthcare. Compassion is at the core of who we are and what we do. For any questions about cleft lip and palate repair, call us to schedule a consultation with a board-certified plastic surgeon.

All surgical procedures by the Plastic Surgery Clinic of Chicago are performed at top hospitals in Chicago and CMS or AAAASF-certified surgical centers for safety.

BEFORE & AFTER

Cleft Lip and Palate Before and After
Cleft Lip and Palate Before and After

 

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3 month follow-up on this patient who wanted improvement in the projection of her chin and definition of the jawline. The patient has retrogenia or a small chin and underwent #chinaugmentation with a #genioplasty. In the pre-operative photos, you can see the chin is short and recessed and therefore I moved the chin forward and down. In the post-operative photos you can see improvement in the projection of the chin, a more defined jawline and neck, and a more balanced lower 1/3 of the face. This case highlights the advantages of a genioplasty versus a chin implant, a chin implant cannot lengthen and advance the chin to the same extent that a genioplasty can. Posted with permission.

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Proud of our research team for getting this important manuscript published in the #1 plastic surgery journal in the world. In this study, we looked at the published literature to develop guidelines on how to treat visual impairments related to droopy eyelids and excess skin of the eyelids.

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One year follow-up on a #BBL or Brazilian butt lift. As you can see from the post-operative photos, the fat that is transferred stays and is permanent. Posted with permission.

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Male patient in his late 60’s who was able to turn back the clock after undergoing a #facelift, #neck lift, #blepharoplasty, and #fattransfer. Pay close attention to the “bags” underneath the eyes, the jawline, and neck. The scars have healed nicely and are inconspicuous even with short hair. In the post-operative photos, the patient has maintained his natural facial features and anatomy, but just looks like a more youthful version of himself. Posted with permission.

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#Primaryrhinoplasty to fix the dorsal hump, droopy tip, and crooked nose. In the post-operative photos, the patient has a nice dorsal profile on side view, the tip has been lifted, and the nose is straight. To evaluate how straight the nose is, look at the dorsal aesthetic lines on bird’s eye view and follow the two light reflexes along the dorsum. Posted with permission.

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Challenging #tertiaryrhinoplasty on this patient who had nasal deviation, a dorsal hump, and an under-rotated/under-projected tip. In the post-operative photos, you can see a straighter nose with more symmetric dorsal aesthetic lines and tip defining points. Posted with permission.

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Honored to be inducted into the Rhinoplasty Society. The Rhinoplasty Society was founded in 1996 by plastic surgeons who have pioneered modern rhinoplasty. The society is dedicated to the education and advancement of nasal surgery.

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Relatively small surgeries can yield big changes. This patient wanted to improve the contour of her chin and the overall profile of her face. The patient’s lower 1/3 of the face and chin were short and set back. Additionally, the patient had asymmetries of the chin and jawline that she wanted improved. The patient underwent a #slidinggenioplasty to achieve these goals where the chin was cut and mobilized forward and downward. In the post-operative photos, you can see a more aesthetic and balanced facial profile. The advantages of a #genioplasty over a #chinimplant are that the chin can be moved in numerous planes, the advancement can be more significant, and asymmetries can be addressed. Posted with permission.

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This patient had a bilateral constricted ear deformity where the top portion of the ear folds over the rest of the ear. In this deformity, the ear appears shorter in height and there are abnormalities of the outer and inner folds of the ear. In the postoperative photos you can visualize the ear is longer in height, the helical rim or outer portion of the ear is lifted up and the antihelical fold or inner portion of the ear is more defined. Posted with permission.


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Challenging #breastaugmentation case where the patient had asymmetries of the breasts in terms of size, shape, and position on the chest. The patient underwent a breast augmentation with #gelimplants with a larger size in the left breast to balance the size difference. The left breast fold was also lowered to match the fold level of the right. Posted with permission.

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