Cleft Lip Repair: Indications, Procedure and After Care

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Cleft lip repair, commonly called cheiloplasty, is a type of surgical procedure that corrects a birth defect in the lip. Cleft lip repair, aside from improving the appearance of a person, prevents future complications that may arise from the condition such as difficulty in speaking, breathing and eating. There are different forms of clefts, from a small notch located in the upper part of the lip to a split extending into the nose. Clefts are usually referred to as unilateral, with a split on just one side, and bilateral, with a split on each side of the lip.

Causes of Cleft Lip

While there are no proven cause of cleft lip, the most commonly attributed factors are heredity, environment, and genetic syndromes. Cleft lip may be inherited from either or both of the parents and may occur as a result of poor health, or exposure to alcohol, cocaine and other toxins during pregnancy. It is also estimated that about 30 percent of those with clefts have genetic syndromes like Down and Pierre Robin.

Cleft Lip Repair Procedure

The decision to perform the operation often depend on the general health of the patient, the location of the defect, and its severity. Most cleft lip repairs are performed in children ages 10 to 12 weeks. Some may need additional operations and regular follow up monitoring to ensure the best results. A team of specialists is often necessary during post operative care. These include the pediatrician, dentist, plastic surgeon, speech and language specialist, psychologist and nutritionist.

Cleft lip repair begins with the individual being injected with general anesthesia, and the cleft demarcated with a methylene ink. Several techniques may be used in cleft lip repair such as Millard rotation which involves the rotation of the whole philtral groove and the curves in the upper lip. The scar is usually adjusted to fall along the central part of the upper lip.

Pros and Cons of the Procedure

The use of the Millard rotation technique in cleft lip repair is popular among surgeons due to its flexibility. The procedure allows the surgeons to create a Cupid’s bow, or curves on the upper part of the lip, and at the same time allow hiding of the suture line. There is also minimal number of tissues discarded when using this technique. One disadvantages of this technique is the risk of the entire lip being shortened vertically.

After Care

After the procedure, a patient has to limit his activities. The use of elbow immobilizers are also recommended to prevent the risk of injuries to the lip. Topical antibiotic ointment is also required to be liberally applied to the lip several times a day. Patients frequently experience some redness and firmness on the area for about a month after the surgery.

References Cleft Lip Repair Fact Sheet: Cleft Lip and Cleft Palate