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.
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.
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The plunging tip in rhinoplasty.
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Can you see the facelift scars? When the facelift scars are placed strategically and closed in a meticulous fashion, the scars are hard to see at the 6-12 month mark.
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Subtle changes on a thick skin patient after a primary rhinoplasty. Not all rhinoplasty procedures require major aesthetic or functional changes. In this case the dorsal hump was removed, the tip was refined, rotated and projected. Posted with permission.
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This is a great case highlighting how we manage a crooked nose after a previous septoplasty. In this case the dorsal hump was removed, the nose straightened by structuring the nose with rib cartilage, and the tip was lifted, rotated and refined. Beautiful and natural 6 month result for this patient. Posted with permission.
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Beautiful breast augmentation result for this patient. In this case we used a 350 cc gel implant, and placed the implant through a periareolar approach and in a submuscular plane. The patient is 5’4” and 125 lbs and went from a B cup to a full C/small D cup. Posted with permission.
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This is a great case to highlight the complexities associated with creating an aesthetic tip and how small changes can yield significant aesthetic improvement. In this case, the patient had a droopy tip, hanging columella, and too much nostril show. In the post-operative views you can visualize a tip that is lifted, more projected, and the presence of a more aesthetic alar-columellar relationship. Happy for this patient and her beautiful and natural result. Posted with permission.
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Proud of our research team for getting this published. In this article, we developed a unique risk assessment tool to predict major complications in facial aesthetic surgery. Thank you to the Aesthetic Surgery Journal for publishing our work.
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The hardest type of rhinoplasties for plastic surgeons to perform are cleft rhinoplasties. A major reason is that the anatomy of the nose and midface are asymmetric, therefore, you have an asymmetric nose sitting on top of an asymmetric midface. In this case, I used rib cartilage to rebuild the cartilage of the nose and fat transfer to improve asymmetries of the midface and lips. In the post-operative frontal views, you can see a straighter nose, the tip has been lifted, and the right nostril has been brought down and inwards. On profile view, you can see the dorsal hump was lowered, the tip of the nose has been lifted, rotated, and refined. The fat was placed in the cheeks and upper lip to improve the midface deficiency that is common in cleft lip patients. Posted with permission.
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