Cartilage molds easily during the first six weeks after birth. Before surgery, your baby might wear an OrthoCleft® retainer, which is a presurgical orthopedic appliance that helps to improve the effects of surgery. Estimates show that children who use presurgical appliances need 20 to 30 percent fewer reconstructive surgeries than those who don’t.
The OrthoCleft® retainer brings gum segments together, reducing the gap in the mouth, stretching the lip muscles, and giving the nose a more even shape. The retainer also can improve sucking and eating abilities while your child waits for surgery.
The OrthoCleft® retainer is made of acrylic and wires. The parts that touch the mouth or nose are soft acrylic, making it easier for your baby to wear. An orthodontist customizes and fits the retainer when your baby is about a week old. Once a month—until the first surgery takes place, at about 3 months—we make a new appliance that fits as your child grows.
In most cases, proper presurgical treatment by a craniofacial surgeon and an orthodontist results in correction with a single surgery (rather than requiring multiple procedures over time). Undergoing fewer surgeries reduces risks and complications, such as those associated with anesthesia.
The goal of repair surgery is to close the cleft lip or palate and repair related problems. Through surgery, we seek to improve your child’s health, function, physical appearance and self-esteem.
Cleft Lip Repair
Cleft lip repair can often be done in one reconstructive surgery to restore the mouth’s normal shape and muscle function. Cleft lip surgery typically happens when your baby is about 3 months old. In addition to improving appearance and function, goals of surgery include:
Cleft Palate Repair
By closing the opening in the roof of the mouth, this repair creates the floor of the nasal cavity. Cleft palate surgery improves your child’s ability to speak, eat and possibly eliminate the need for modified bottles and feeding techniques. It typically occurs when your baby is 9 to 12 months old. Some children who have cleft palates will need additional surgeries as they develop—to help with speech, improve the appearance of the lip, close openings near the mouth or add bone to the upper gum to allow for proper gum development.
When the cleft also affects the shape of the nose, additional procedures after age four can help to:
- Improve symmetry between the nostrils.
- Create an adequate length of tissue separating the nostrils.
- Minimize the appearance of a flattened tip of the nose or a nose that pulls downward.
Therapy After Surgery
After cleft repair surgery, our speech-language pathologists will work with your child to improve speech. Your treatment plan might also include collaboration with audiologists and ear, nose and throat (ENT) specialists if your child has hearing problems.