What to Expect in Cleft Lip Repair

A cleft lip is a split or separation of the two side of the upper lip which is present at birth. The goal of cleft lip surgery is to restore normal appearance and function to the upper lip. The surgical repair of cleft lip is not performed until sometime after the infant reaches 10 pounds in weight, is at least 10 weeks old, and has a hemoglobin (a protein in red blood cells that indirectly indicates whether there is a risk of excessive bleeding) count of 10 grams. Doctors who treat cleft lip often refer to this as the “rule of 10s.”

A cleft lip not only affects facial appearance, but can have many functional consequences. These include the child’s ability to speak, eat, and breathe properly. As is the case with cleft palates, children born with a facial cleft usually require a team-based approach to achieve the best possible result. The care for a cleft lip is most effectively managed when an interdisciplinary team of specialists works not only with your child, but also with you as parents to discuss and arrive at a comprehensive treatment plan.

As noted in one of our prior blogs, there are several different classifications of cleft lip such as unilateral incomplete, unilateral complete, bilateral incomplete, and bilateral complete. A unilateral cleft lip, more frequently occurring on the left side, is more common than a bilateral cleft lip. While surgical repair of the cleft lip usually takes place at approximately three to four months of age, the exact timing of the procedure will depend upon your baby’s overall health status as determined by the surgeon. Cleft lip can often be repaired in a single surgery, but larger and more extensive cleft defects may necessitate one or more additional procedures.

For infants born with a complete cleft lip, the first surgical procedure is likely to be a lip adhesion to convert the complete cleft lip to an incomplete one and to reduce incision tension as well. A follow-up surgery to complete the repair (sometimes called a cheiloplasty) is usually performed within a couple of months thereafter. The overall goal of cleft repair surgery is to restore to the fullest extent possible the cosmetic appearance and function of the lip, and to aid in nursing, feeding, and later speech development. If scar tissue persists as your child gets older, skilled plastic surgeons can often perform tissue revision procedures in order to diminish residual effects.


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