A cleft lip is a facial deformity that develops very early in pregnancy. It occurs when there is not enough tissue in the mouth area, and what tissue is present does not fuse together properly. A cleft palate is a similar deformity affecting the roof of the mouth. The two deformities can occur together or separately. Facial reconstruction can effectively correct a cleft lip and cleft palate.
Types of cleft lip
Cleft lip ranges in severity. In the mildest cases, the cleft lip is a barely noticeable notch in the upper lip. Cleft lip is described as complete or incomplete. In a complete cleft lip, the cleft extends all the way up to the base of the nose. In an incomplete cleft lip, the cleft stops somewhere short of the nose. Cleft lip can also be unilateral or bilateral, which means they can affect one side of the mouth or both sides.
How is cleft lip treated?
Except in the very mildest cases, cleft lip requires facial reconstruction surgery. The operation will typically be performed when the patient is about 12 weeks old. The infant will be placed under general anesthesia. Depending on the patient’s needs, our surgeon will reconstruct such features as the philtrum or groove above the upper lip. He will then sew the cleft closed. If the child has a bilateral cleft, our surgeon may choose to operate on one cleft at a time, so the patient will undergo two surgeries within several weeks of each other.
If the patient has a complete cleft lip, they also sometimes have a cleft in the gums and even the upper jaw bone. In many cases, our surgeon will attempt to repair the cleft in the gums at the same time that they repair the cleft lip. A successful operation on the gums may prevent the child from needing a bone graft in the upper jaw later on.
Children who need to have a cleft in the upper jaw (alveolar cleft) repaired usually undergo the necessary surgery when they are between seven and nine years old. A bone graft will be harvested from a donor area of the body and used to fill in the cleft in the upper jaw.
Children with complete cleft lips involving the nose may also need nose surgery. Such surgery is often performed when the child is significantly older; some patients don’t get rhinoplasty until they are in their teens.
What Is Nasoalveolar Molding?
Nasoalveolar molding or NAM is a therapy used to prepare infants with cleft lip and/or cleft palate for their surgery. Babies have very flexible cartilage and skin, and NAM takes advantage of that fact. Our surgeon installs a retainer-like device in the child’s mouth that gradually narrows the cleft and improves the shape of the nose and the alignment of the gums. It can thus reduce the need for later surgery.
Fortunately, cleft lip and cleft palate have been successfully treated with facial reconstruction surgery for years. If you or your child needs facial reconstruction, our trusted plastic surgeon can help you learn more about the procedure at Athena Plastic Surgery in West Palm Beach. Contact us at either of our offices in Palm Beach Gardens or Stuart to schedule your consultation.