If your child was born with a cleft lip, surgical intervention at an early age is the best option. While no parent wants to put their child through surgery, both Shitel Patel, MD, and Jacqueline Wegge, MD, at Up Pediatric Plastic Surgery have extensive training in craniofacial plastic surgery, giving you peace of mind knowing that your child is in good hands. If you’re in Houston or Webster, Texas, call or use the online form to schedule a consultation.
If your child only has a cleft lip and their palate is in good shape, you should plan on having the surgeon at Up Pediatric Plastic Surgery perform the cleft lip repair at about three months of age. The reason this is done so early is that the repair can be folded into your child’s natural growth and development.
Of course, if you were unable to get your child’s cleft lip repaired at three months, the surgeons are able to correct this abnormality at any time.
Whether your child has an incomplete or complete cleft lip, the surgeons at Up Pediatric Plastic Surgery repair them in a similar manner. The treatment of a microform cleft lip is less extensive, and your surgeon can sometimes do it with only small incisions on the inside of your child’s mouth.
For a complete cleft lip repair, the surgeon makes cuts in the skin on the inside of your child’s mouth and nose, and sometimes in their nostrils.
From there, the surgeon carefully repairs the inside lining of your child’s mouth and lips, the muscles of the lips, and the skin of their lip and nose. Once completed, the surgeon uses absorbable sutures and covers the incisions with skin glue.
After surgery, you usually spend one night in the hospital to make sure your child is drinking well before you go home. As soon as your child wakes up, you may feed them as you normally do.
The surgery itself is not particularly painful, but your child may be irritable or not want to feed at first because things feel different, and they need to get used to their new mouth.
Once you get home, it’s normal for there to be some bloody drainage from your child’s mouth and nose for the first few days to a week after surgery. You may clean the outside of your child’s nose gently with a warm washcloth or cotton swabs with peroxide, but don’t stick any objects inside the nose, including suction bulbs.
After surgery, the doctors often use nasal stents, which are hollow tubes made of soft plastic that are taped into your child’s nostrils. Your child wears the stents for three months after surgery to allow the doctor to gradually increase their size to shape the nostrils for a better overall result. You need to remove and clean these daily and apply ointment to your child’s nose and lip twice a day.
As part of the normal course of healing after surgery, it’s common for your child to have some lip contracture. As their tissues heal, they become firm and tight, causing your child’s lip to pull up and appear shorter, and the lip may even look notched. Rest assured, this goes away as their tissues soften and relax, but sometimes this process can take one to two years before it’s complete.
Once the incisions are healed, the surgeons at Up Pediatric Plastic Surgery let you know when you may begin scar care. This usually consists of daily scar massage with your favorite lotion to break up and soften the scar. You may also begin silicone treatments or use scar creams.
You should also use sunscreen any time your child goes outside. Exposure to sunlight will darken the scar while it’s in the process of healing.
It’s important to remember that many of your child’s structures haven’t formed correctly, especially the cartilages of the nose, so it won’t be possible to make everything appear perfectly symmetrical during a cleft lip repair. Most children need further surgery on their noses, and sometimes their lip again, at some later point.
In general, it’s best to have a rhinoplasty, or nose job, done once your child is done with growth at 16-18 years of age. By this age, their cartilage is strong enough for the surgeons to strengthen and reposition it. As well, if your child’s nose needs extensive repair, where the bones need to be broken and part of the septum needs to be removed to straighten the nose, these repairs are more sustainable at this stage of their development.
To discuss cleft lip repair for your child, call Up Pediatric Plastic Surgery, or schedule an appointment by filling out the form online.