General Information

DEFINITION--Repair of a hereditary deformity of the upper lip called a "cleft lip" or "harelip" in which lip, nose and palate structures do not fuse correctly prior to birth. Frequently, this deformity extends to the roof of the mouth (palate) and can hamper development of normal speech. Surgery is usually performed when the patient is about 3 months old. If a cleft palate exists, it is usually repaired in a separate surgery when the patient is 12 to 18 months old.

BODY PARTS INVOLVED--Upper lip; muscles surrounding the mouth; membrane lining the mouth; roof of the mouth (palate).

REASONS FOR SURGERY

• Prevention of nursing and feeding problems that can retard normal growth.
• Rearrangement of the distorted tissues to make the lip and palate function normally and appear as normal as possible.

SURGICAL RISK INCREASES WITH

• Other congenital abnormalities.
• Poor nutrition. This often results from inability to nurse properly because of the deformity.

What To Expect

WHO OPERATES--Plastic and reconstructive surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies.
• After surgery: Blood studies.

ANESTHESIA

• Local anesthesia by injection.
• General anesthesia by a combination of injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• The area where the lip, mouth and palate should be are marked.
• The skin to be relocated is cut free from its underlying tissue. Bleeding is controlled with clamps or medication (epinephrine).
• The skin flaps are adjusted to their desired position.
• The muscles and skin edges are reconstructed with fine sutures, which usually can be removed about 7 to 10 days after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.

AVERAGE HOSPITAL STAY--5 to 7 days.

PROBABLE OUTCOME--Expect complete healing without complications. Allow about 4 weeks for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• A hard ridge should form along the incision. As it heals, the ridge will recede gradually.
• Bathe the child as usual. You may wash the incision gently with mild unscented soap.

MEDICATION---

Your doctor may prescribe:

• Pain relievers. Don't give the child prescription pain medication longer than 4 to 7 days. Use only as much as the child needs. > Antibiotics to fight infection.

ACTIVITY---No restrictions.

DIET---No special diet.

Call Your Doctor If

> Pain, swelling, redness, drainage or bleeding increases in the surgical area.