 Surgical repair of the lip The only way to repair a cleft lip is by surgery. The lip repair is usually done between 3 and 6 months after birth. Plastic surgeons carry out this operation under general anaesthesia. Part of the operation involves stitching the skin of the lip together. The operation may also involve improving the baby’s nose. If the baby also has a cleft palate, some surgeons might close the front part at the same operation. Usually, a blood sample and other tests are taken to make sure that the baby is fi t enough for the operation. On the day of the operation, your baby will not have any food for a few hours beforehand to reduce the chance of being sick (vomiting). Sometimes, a calming medicine (pre-med) is given by injection or as a drink before the operation. Afterwards you might see some bleeding from the mouth. There will be some stitches, swelling and crusting on the lip. If the nose was involved in the operation, a small piece of foam might be used to hold its new shape. You might fi nd that splints are on your baby’s arms to prevent touching the stitches. The baby’s scars often become red and swollen afterwards, but usually only for a short time.  Be prepared for your baby to look different after the operation. Use a dummy to pacify your baby only when necessary, as some surgeons are concerned about their effect on the wound healing following the operation. Take advice on whether to breast-feed, bottle or spoon-feed immediately after the operation. Surgical repair of the palate Most surgeons repair the palate from about 4 months to 12 months of age. It is thought that repairing the palate before the child learns to speak will help in speech development. The palate is usually repaired in layers, with as little surgery to the upper jaw and hard palate as possible. The muscles of the soft palate are reconstructed so that it can work properly during speech and swallowing. Sometimes, the gap in the upper gum area is closed at this stage and sometimes later, depending on the surgeon. A blood sample and other tests will be taken to make sure the baby will be fi t enough for the operation. On the day of the operation, your baby will not have any food for a few hours beforehand to reduce the chance of being sick (vomiting). A calming medicine (pre-med) is given by injection or as a drink.  As with the lip repair, you might see some bleeding from the mouth. There will be some stitches in the palate. If the nose was involved in the operation, a small piece of foam might be used to hold its new shape. You might fi nd that splints are on your baby’s arms to prevent touching the stitches. Use a dummy to pacify your baby only when necessary, as some surgeons are concerned about their effect on the wound healing following the operation. Take advice on whether to breast feed, bottle or spoon-feed immediately after the operation. In some cases, the repair is unable to withstand the pressure of bottle or breast-feeding and holes can open in the palate. Most often, these holes are small and contract in time and close on their own or become very small. Adjustment surgery Occasionally further surgery is required to adjust the original repair. A small hole (fi stula) might remain in the palate and might need to be closed if it affects speech or allows food or drink to enter the nose. About 1 in 5 children with repaired clefts might need further surgery to improve speech (pharyngoplasty). The timing of this surgery varies from patient to patient and depends on the assessment of a cleft team. REFERENCE: “A PARENTS' GUIDE TO THE TREATMENT OF CLEFT LIP AND PALATE” / "‘n OUER-HANDELING VIR DIE BEHANDELING VAN ‘n GESPLETE LIP ENVERHEMELTE" / ISIKHOKELO KUBAZALI NGONYANGO LOMLEBE OCANDEKILEYO NENKALAKAHLA EVULEKILEYO. © Haydn Bellardie 2006. | You are fashioned and formed in the image of God. With God all things are possible. You are destined for great things! You have the most beautiful smile. Outside beauty fades, what really counts at the end of the day is the state of your heart. Anthea, Cape Town People may tease you as you get older, especially the children in your school. Whatever you do, do not let them get to you. You are special, you are something they can never be. We love you for who you are, and that little scar on your lip made us love you more. Those that can't see further than that scar are not worth your time. Just remember 'There are people who will love you always'. Barry, Cape Town |
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Surgery |