One in 800 children are born with a cleft palate or lip, which occurs when the left and right sides of the lip and roof of the mouth do not grow together completely. The lip and the palate develop independently, so it is possible for a child to have a cleft lip, a cleft palate or variations of both. Surgery to repair a cleft lip or palate is very common and unique to each patient. Typically, surgery is performed when the child is approximately ten weeks old. Dr. Hoffmann has extensive experience in this type of procedure and will develop a surgery plan special to your child’s individual needs.


Cleft Lip Surgery
A cleft lip can range in severity from a slight notch in the red part of the upper lip to a complete separation of the lip extending into the nose. Clefts can occur on one or both sides of the upper lip.

Dr. Hoffmann will make an incision on either side of the cleft from the mouth into the nostril. He will then turn the dark pink outer portion of the cleft down and pull the muscle and the skin of the lip together to close the separation. Muscle function and the normal "cupid's bow" shape of the mouth are restored. The nostril deformity often associated with cleft lip may also be improved at the time of lip repair or in a later surgery.


Cleft Palate Surgery
A cleft palate may involve only a small portion at the back of the roof of the mouth or it may involve a complete separation that extends from the front to the back of the mouth. Cleft palate repair requires more extensive surgery than the cleft lip procedure and is usually done when the child is between nine and 18 months.

Dr. Hoffmann will make an incision on one or both sides of the separation, moving tissue from each side of the cleft to the center, or midline, of the roof of the mouth. This rebuilds the palate, joining muscle together and providing enough length to promote healthy eating and speech habits.


Recovery
Your child may feel some soreness and pain, which is easily be controlled by medication. During this period your child may not eat or drink as much as usual, so an intravenous line may be used to maintain fluid levels. You will advised on how to feed your child during the first few weeks after surgery.


Potential Risks and Complications
In cleft lip surgery, the most common problem is asymmetry, when one side of the mouth and nose does not match the other side. The goal of cleft lip surgery is to close the separation in the first operation and correct other appearance related imperfections during subsequent surgeries.

In cleft palate surgery, the goal is to close the opening in the roof of the mouth to promote proper eating abilities and speech development. Occasionally, poor healing in the palate or poor speech may require a second surgery. Additional procedures may be needed to correct any appearance abnormalities.

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