Nasoalveolar molding, or NAM for short, is a nonsurgical, minimally invasive approach to reshaping the lips, gums, and nose prior to cleft lip and palate surgery.
Children born with an incomplete formation of the upper lip, or a cleft lip, often require surgical intervention to correct the problem so that breathing, eating, and speaking can develop normally. The same applies to a cleft palate, a similar defect in the roof of the mouth. While these can occur individually, they frequently appear together, exacerbating the severity of the condition as well as the procedures required to repair them.
Nasoalveolar molding is an innovative method used primarily in children that have particularly wide or large clefts. 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.
Traditionally, a child with a complete cleft lip, including a cleft in the gum, or wide cleft lip and palate might require multiple surgeries to fully restore appearance and functionality to the lip, nose and mouth. Nasoalveolar molding is not an alternative to surgery; however, it has greatly improved cleft care by reducing the size of the cleft prior to the initial surgery and decreasing the number of necessary procedures.
NAM is used on infants to gently direct the position of the gums, nose, and lips while the tissue is soft and easily formed. If your newborn is affected by a cleft lip or palate, consult with a plastic surgeon to see if nasoalveolar molding is a viable treatment option.
Nasoalveolar molding can begin as earlier as three to four weeks of age. The customized plastic plate is shaped specifically for your baby’s mouth and looks much like a retainer. It is held in place with rubber bands and is usually taped to the baby’s cheeks to avoid being dislodged.
Infants wear the molding plate continuously, even when feeding, for the first few months after birth. Every one to two weeks, the plate is modified in order to mold the gums to close the gap between them.
NAM not only reduces the cleft inside the mouth, but also narrows the gap in the cleft lip, as well as lifts and narrows the nose. The technique is not painful; instead, nasoalveolar molding gently guides the growth of affected areas.
Cleft lip and palate surgery is performed after the molding regiment is complete, typically between three and six months of age. During this procedure, flaps of tissue are created and gently brought together to close the gap.
There is no recovery period for nasoalveolar molding, since it is a nonsurgical method. There is, however, a recovery period after the cleft lip and palate repair. The only known risks associated with NAM are skin and gum irritation, since it is a minimally invasive technique that does not require any incisions or surgical intervention by itself.
NAM is designed to reduce not only the number of procedures required to treat a cleft lip and palate, but also the overall cost of the treatment. NAM therapy costs can range from $4,000 to $6,000 depending on the recommended treatment and extent of the cleft. Be sure to discuss all costs with your plastic surgeon during your consultation. Your medical insurance may cover some or all of the cost associated with nasoalveolar molding; contact your health insurance provider before your child undergoes the procedure.
The Plastic Surgery Clinic of Chicago is comprised of experts in pediatric care and reconstructive surgery. At our clinic, your child’s care will be in the hands of a board-certified plastic surgeon that has specialty training in both NAM and cleft surgery. You can rest assured that the personalized attention your child gets now is the same care that he or she will receive throughout their entire treatment plan. For questions about nasoalveolar molding, call our clinic to schedule a consultation.