Cleft Lip Surgery - first correctional procedure to restore facial features

Cleft lip and cleft palate is a common birth defect. It can be seen in the form of splits in the lips and abnormal openings in the mouth. Cleft Lip and Cleft Palate have a deep effect on babies’ growth and development if left untreated.

Parents are often unaware of the situation and do not know the course to follow in the case that their child is born with a cleft lip and cleft palate. This is the reason July is globally observed as cleft lip and cleft palate awareness month in order to make the people aware of the reasons, the treatment available, and the necessity to get the issue at hand treated.

This blog, penned down by Pandit Clinic’s expert Plastic and Reconstructive surgeon, Dr Shrirang Pandit, aims at explaining in detail all the questions that revolve around cleft lip which is actually a major issue. Often, the babies born with this defect have a rather different appearance which is a cause of huge concern for their parents and close family members.

The correctional surgery involved in treating the issue involves multiple steps and the first and the most important aspect of the procedure is cleft lip surgery. However, before diving into the procedure, let us first look at what cleft lip and cleft palate is and what might be the reasons for the issue at hand.

What Is The Difference Between Cleft Lip And Cleft Palate?

Cleft Lip
Cleft Lip is the presence of a hollow space in either one or both sides of the lip. Having a cleft lip drastically changes the appearance of the baby as it seems like a major part of the face is missing. This hampers the appearance of the baby. Cleft Lip Surgery is the first correctional procedure which aims to restore the original features of the face

Cleft Palate
The palate is essentially the roof of the mouth. It is generally divided into the soft palate which is the soft, fleshy part of the roof made of tissue and muscle at the back of the mouth and the hard palate which is the bony part behind the front teeth. In the case of a cleft palate, the roof appears to be missing and there is a cavity present there. This defect can occur either unilaterally or bilaterally. In certain cases, the cleft is only in one part of the palate, which is the soft palate. This is also referred to as an incomplete cleft palate. In certain cases, the cleft runs through the entirety of the palate and this is referred to as complete cleft palate.

Children can have either a cleft lip or cleft palate. There is also a chance that both these defects are present together.

What Causes Cleft Lip Or Cleft Palate During Pregnancy?

During the time of pregnancy, if the mother has certain nutritional deficiencies, it can be a contributing factor to the presence of a cleft lip and/or cleft palate. Specifically, if the mother has a deficiency of Vitamin B6, it is likely that this defect will be present in the baby

The reasons for having a cleft lip and cleft palate are still being studied by leading research institutions However, there is strong speculation that these issues arrive as a result of genetic factors.

What Is The Reason For Cleft Lip?

A cleft lip is a deformity which begins to form very early in the stages of fetal development. The reason behind this issue is still being speculated. However, the occurrence of the issue is highly hereditary. The role of genetic factors is a strong one.

During the time of pregnancy, if the mother has certain nutritional deficiencies, it can be a contributing factor to the presence of a cleft lip. Specifically, if the mother has a deficiency of Vitamin B6, it is likely that this defect will be present in the baby.

One of the most important aspects to absolutely disregard as the reason for a cleft lip or cleft palate are certain beliefs that revolve around the condition. More than often, doctors come across people who strongly believe in various superstitions like the presence of a solar eclipse, the punishment of God, and other such factors are responsible for the defects in their child. It is absolutely necessary to stay away from such thoughts as these superstitions have nothing to do with the issue of having cleft lip or cleft palate.

What Is The Treatment For Cleft Lip?

Role of Doctors

Treatment of cleft lip on time is what is of utmost importance. The surgeries have to be performed at various ages in different stages.
It requires a team of various doctors that cater to every individual issue meticulously at different stages of the treatment. The team generally encompasses:

- An expert pediatrician to monitor the overall health of the baby
- An anesthesiologist to administer anesthesia so that the baby does not feel pain or discomfort throughout the procedure
- ENT specialist
- Oral Maxillofacial surgeon,
- Speech therapist

All of these are led by an expert plastic surgeon. The role of the ENT specialist, an oral maxillofacial surgeon, and a speech therapist arrives quite later in the multiple stages of the surgery.

Procedure for performing a Cleft Lip Surgery

The first surgery involving the correction of the lip must be performed three to six months after the baby is born. All of this needs to be decided after taking into consideration the child’s overall health and well- being. The role of a pediatrician is an important one here.
The following steps are involved in the surgery:

The first step involves the administration of anesthesia. General anesthesia along with intravenous sedation is preferred. However, the best choice for the baby will be decided upon by the doctor taking into consideration all the aspects at hand.
The second step involves joining the cleft lip in order to restore a normal function and appearance to the lips. During this procedure, flaps are created on either side of the cleft lip with the help of incisions. These flaps of skin, tissues, and intraoral muscles are then pulled together and stitched in order to give a general appearance of the lips and the nose.
The next step involves the closing of the incisions. Either absorbable sutures or removable sutures are used for the same.
There is a visible scar at the site of the procedure. However, this is generally aligned with the contour of the nose. As the child grows, the scar gradually fades and one can see a noticeable improvement in the appearance as well as the functionality.

What Are The Benefits Of Cleft Lip Surgery?

Having a cleft lip not only affects the appearance of the person, but also certain abilities like speaking, eating, and growth of teeth. Hence, it is necessary to understand that a cleft lip surgery is more than just a cosmetic procedure. It is also performed so that the baby has proper growth and improved functionality.

The appearance of the lips can be changed in the following ways:

Formation of the cupid’s bow.
Creating adequate space between the lips and the nose
Closing the cleft and creating a scar that runs through the natural contour of the upper lips.

Once the appearance is altered and the cleft is closed, it greatly improves the function of the lips and the nose.

A cleft lip is not a single surgery that is performed in order to rectify the issue. In some cases, multiple surgeries are required at different ages depending upon the situation at hand. After the first surgery is completed to rectify the cleft lip, the second one involves the correction of the cleft palate which is between the ages 12 to 18 months. Surgery might be performed at age 5 years to correct any defects within the nose or to improve speech. The next important surgery involves the reconstruction of the gums with the help of bone graft. The last step of the surgery is done in between 18 to 20 years to correct the defects of the nose and the jaws.

It is necessary to have a proper consultation with your plastic surgeon in order to decide the course of the treatment.

We hope that this blog helped you to understand Cleft Lip and the procedure revolving around it.

BOOK APPOINTMENT

If you have any questions or need more information about a procedure, please schedule an appointment with Dr Shrirang Pandit at Pandit Clinic, Pune.