Cleft Lip and Palate Repair

Also known as: cleft lip surgery, cleft lip repair, cleft palate surgery, cleft palate repair.

What is cleft lip and palate repair?

Cleft lip and palate are common facial birth defects that are often seen together. They involve a gap in the lip and palate of the newborn baby. Cleft lip and palate repair refers to the surgical procedures that are used to repair these problems.

  • Cleft lip repair is performed under general anesthesia, typically between 3-4 months of age. The lip skin and muscle are rearranged to close the cleft.
  • The cleft palate repair is typically done when the child is older, between the ages 12-18 months. This repair is performed by mobilizing the tissue inside the mouth and the bringing it together to close the gap.

What happens during cleft lip and palate repair?

Your child will be admitted to the hospital the morning of the surgery. You will receive a call from the hospital the day before surgery with instructions on when to feed your child last and what time to be at the hospital. Your child will have an intravenous line until he or she is able to drink well by mouth. You will be able to feed your baby clear liquids shortly after surgery. Once your baby is tolerating the clear liquids well, you will be able to add formula and soft foods gradually. Your child will be unable to eat solid foods or use a pacifier after surgery until your physician clears you.

What to expect after cleft lip and palate surgery?

After surgery, your child will have soft immobilizers on the arms to protect the incision site. You will be asked to keep these on for approximately 2 weeks. You can take them off for baths and short rest periods always making sure that the child’s hands do not touch the lips. Your child will also go home with a metal loop, called a logan bow, over the lip that will help protect the lip from injury. Do not remove the logan bow. If the tape becomes loose, add more tape to secure it. The logan bow will stay on for approximately one week.

Pain Management after cleft lip and palate surgery

Your child will initially receive pain medicine through the IV line. Once he or she can tolerate food, the pain medicine will be given by mouth. After you go home, your child may still experience some discomfort that can be relieved with Tylenol or Motrin. Your doctor will also provide you with a prescription for a stronger pain medication if needed.

  • Stiches - The stitches that are used are self dissolvable. They will generally come out in about 7 days.
  • Swelling and Drainage - It is okay to have small amounts of drainage or blood from the incision site or nose. This drainage will decrease over time.
  • Cleaning the incision - It is important to keep the incision site clean. It can be cleaned with mild soap and water. After cleaning, you should apply a small amount of antibiotic ointment.

Once you are home

Most children will go home the day after surgery. You will have a follow-up appointment about a week after surgery.

What are the risk factors of the procedure?

Bleeding, infection, reactions to the anesthesia, breathing problems and additional surgeries are all potential complications of cleft lip and palate repair.

When to call the doctor:

  • Fever of 101 or higher
  • Drainage with foul odor or yellow-green drainage
  • Increased amount of blood from the incision site
  • If your child is not eating or drinking enough or appears to be dehydrated (little or no urine, no tears)
  • If your child is not breathing well

Reviewed by: Chad A Perlyn, MD

This page was last updated on: June 29, 2021 09:23 AM

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Dr. Chad Perlyn is a pediatric plastic surgeon specializing in craniofacial surgery.