Cleft Lip Surgery

What is Cleft Lip Surgery?

The cleft of the lip can be unilateral (affecting the right or left) or bilateral (affecting both sides). In the cleft lip operation, incisions are made and the separate portions of the lip are brought together to form a single full lip. The repair of the child's lip generally takes place at age 10 to 12 weeks, although optimum timing of repairs may differ from child to child. There are several methods of repairing a cleft lip (also called a cheiloplasty), and the surgeon will choose the type of repair that is appropriate depending on the type of cleft lip your baby has. As your child grows older, he may require an additional operation called a lip revision in order to correct any distortions that may occur in the lip over time.

Scheduling an Initial Consultation

You may contact the University of Michigan's Craniofacial Anomalies Clinic directly at (734) 764-2582. Your child's pediatrician can also assist you in providing a referral as well as the medical information you will need to provide during the initial consultation.

List of Physicians Who Perform Cleft Lip & Palate Surgery

For details about education, experience, and specialty in this clinical area, please visit these physician profile pages:

• Steven Buchman, M.D.
• Steven Kasten, M.D.

Preparing for Your Child's Surgery

You will be given a pre-operative information packet that explains everything you should do and know before your child's surgery date. Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and taking or avoiding certain vitamins and medications.

Click here for a partial list of hotels and other lodging in Ann Arbor that offer discounts for patient's families. To reach the Patient & Visitor Hotel Accomodations Program, call (800) 544-8684 or (734) 936-0135.

Mott Operating & Recovery Rooms

Your child's surgery will take place at the University of Michigan's C.S. Mott Children's Hospital which provides state-of-the-art, "child friendly" surgical suites and recovery areas. Visit the Mott Children's Hospital OR & Recovery Room page for a "virtual tour" of the operating and recovery areas, before, during, and after surgery information, frequently asked questions and answers for parents and children, and much more.

Types of Anesthesia

The cleft lip repair is done in an operating room under general anesthesia so that your child will sleep throughout the entire procedure. Anesthesiologists and nurse anesthetists at Mott Children's Hospital are all trained and experienced in pediatric anesthesia and the care of pediatric patients. Your child will remain comfortable throughout the entire procedure.

After Your Child's Surgery

Postoperatively, your child will have an IV, and may need to sleep in a crib with the head of the crib propped up to decrease swelling. Your child can be discharged from the hospital if he is taking liquids well (usually one or two days). Prescriptions will be written for pain medication (usually Tylenol™ with codeine), and ointment for his suture line.

Appearance

After surgery, your child's lip may be red with some swelling. Small strips of tape will most likely placed across the incision to reinforce the repair, to lessen the tension on the suture line, and to protect the lip from rubbing or an accidental bump.

Feeding Your Child

Feeding of your child will also change after surgery. An older child may be fed with a cup, and a baby should be fed with a syringe attached to a piece of rubber tubing or the side of a spoon. In some cases, it may be acceptable to continue feeding the baby with the flexible Mead Johnson™ nurser. Breast feeding may not be possible immediately after surgery.

Pain

Your child's pain can be managed with medication. After an operation, there is usually a change in your child's behavior, including fussiness and refusal to eat with the new feeding method. Holding and rocking your child are comfort measures that can be provided.

Wound Care

No dressing over the lip is needed, but an antibiotic ointment will be applied once the strips of tape are removed. The lip sutures should be cleaned thoroughly and gently. Crusted drainage may be removed using hydrogen peroxide diluted with water. A thin layer of antibiotic ointment should be kept on the suture line at all times. Your child may have soft arm restraints on to prevent scratching at the suture line. These restraints, called "No no's" are necessary after surgery, and will need to be worn for ten to fourteen days after the surgery. They can be removed, one at a time, every two to three hours in order to exercise the baby's arms.

Sun exposure should be minimized for six months to reduce darkening of the scar. There will be a scar on your child's lip that will become less noticeable over time but will never completely disappear.