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Cleft Lip Repair

When should my child undergo surgery?

Parents often ask our Cleft and Craniofacial team members: "When is the best time to perform cleft lip repair?" For parents, there are sometimes conflicting needs of limiting the risks to performing surgery on a very young child and wanting their child to undergo cleft lip surgery as soon as possible.

Currently, the typical time to perform cleft lip repair is three months for children with a unilateral cleft lip (a lip separation on one side) and five months with a bilateral cleft lip (a lip separation on two sides). These times have been determined by two important factors: safe anesthesia and obtaining the best possible results.

Under the care of an experienced pediatric anesthesiologist, most infants can safely undergo surgery. However, surgery on a newborn child does have increased risk, therefore, non-emergency surgery (or elective surgery such as cleft lip repair) is usually delayed until several months after birth. If the child was premature, there may be an even longer delay. Also, newborn children are quite small and sometimes thin. After about three months of age, infants are typically plumper and with fuller facial features, making cleft lip repair easier and more predictable. As bilateral cleft lip repair is much more challenging than unilateral cleft lip repair, surgeons typically wait until about five months of age before performing surgery. Also some cleft teams, including our team, may perform molding treatment to the lip, gums and/or nose to align these tissues before cleft lip repair. These therapies can greatly improve the results of cleft lip repair; however, it can take many months to achieve their full effect.

Remember, the first surgery is the "best shot" at your child's repair. Waiting for the right time for your child's cleft lip repair will help you get the best results possible. Ask your plastic surgeon when is the best time to perform cleft lip repair.

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