What is cleft lip repair?

Cleft lip repair is surgery to fix a split (cleft) in the lip. The doctor will make a cut along the edges of the cleft lip. This cut is called an incision. It will go up into the nose. The doctor will use stitches to bring the cut edges together to shape the upper lip and nostrils.

Most children have a short hospital stay after surgery. It usually takes about 3 to 4 weeks for the incision to heal. The incision will leave a scar. It will fade and become softer and flatter in the months and years after surgery.

After surgery, it will probably be easier for your child to eat, breathe, and speak. Some children need more surgery on their lips, noses, or mouths as they get older to improve their speech or the appearance of their scar.

Activity

• Allow your child to slowly become more active. Have him or her rest as much as needed. Make sure your child gets enough sleep at night.
• Put your child to sleep on his or her back. This will prevent your child from rubbing his or her lip on a blanket or the crib mattress.
• For the first few weeks after surgery:
  • Do not allow your child to do activities that could damage the incision.
  • Do not use a pacifier or let your child put a hand, toys, or other objects in his or her mouth.

Diet

• Follow the doctor's instructions for feeding your child. You may need to use a special bottle or syringe for the first few weeks to give your child breast milk or formula.
• Give your child plenty of fluids.
• You may notice a change in your child's bowel habits right after surgery. This is common. If your child has not had a bowel movement after a couple of days, call the doctor.

Medicines

• Your doctor will tell you if and when your child can restart his or her medicines. The doctor will also give you instructions about your child taking any new medicines.
• Make sure that your child takes pain medicines exactly as directed.
  • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
  • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
• If you think pain medicine is making your child sick to his or her stomach:
  • Give your child the medicine after meals (unless the doctor has told you not to).
  • Ask your child's doctor for a different pain medicine.
• Your doctor may prescribe antibiotics. Have your child take them as directed. Do not stop giving them to your child just because he or she feels better. Your child needs to take the full course of antibiotics.

Incision care

• If there are strips of tape on the incision, leave the tape on for a week or until it falls off.
• If your doctor told you how to care for your incision, follow your doctor's instructions. If you did not get instructions, follow this general advice:
  • After the first 24 to 48 hours, wash around the incision with clean water 2 times a day. Don't use hydrogen peroxide or alcohol, which can slow healing.
• Keep the area clean and dry.

Other instructions

• After the incision heals, you can gently massage the scar each day. This may help soften the scar.
• Protect the scar from the sun for at least 3 to 4 months. Scars sunburn easily, and sun can make the scar more noticeable. After the cut has healed, apply sunscreen every time before your child goes outside.

Surgery can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's surgery.

Preparing for surgery

• Talk to your child about the surgery. Tell your child that the surgery will probably make it easier to eat, breathe, and speak. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the surgery. Your doctor will tell you if your child should stop taking any of them before the surgery and how soon to do it.
• Ask if a special tour of the surgery area and hospital is available. This may make your child feel less nervous about what happens.
• Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.

The day before surgery

• A nurse may call you (or you may need to call the hospital). This is to confirm the time and date of your child's surgery and answer any questions.
• Remember to follow your doctor's instructions about your child taking or stopping medicines before surgery. This includes over-the-counter medicines.

Cleft lip repair is surgery to fix a split (cleft) in the lip. The doctor made a cut (incision) along the edges of the cleft lip extending up into the nose. Then the doctor used stitches to bring the cut edges together to shape the upper lip and nostrils.

Your child may need pain medicine for the first few days after surgery. The area around your child's mouth will be swollen for the first week or two after surgery. Your child may be more fussy than usual.

Most children are back to their usual behavior about a week after surgery. It usually takes about 3 to 4 weeks for the incision to heal. The incision will leave a pink or red scar. You can expect the scar to feel hard and tight at first. The scar should fade and become softer and flatter in the months and years after surgery.

Your child may need to wear a wire guard across their upper lip. This helps prevent the lip from stretching and protects the stitches from breaking or the skin edges from separating. Your child also may need to wear splints on their arms. The splints keep your child's arms straight so that your child can't rub the incision while it heals. Your child may need to wear the lip guard and arm splints for 10 to 14 days. If your child has a lip guard or arm splints, it is important to wear them for as long as the doctor recommends.

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, the surgery may be canceled. If the doctor told you to have your child take his or her medicines on the day of surgery, have your child take them with only a sip of water.
• Have your child take a bath or shower before you come in. Do not apply lotion or deodorant.
• Your child may brush his or her teeth. But tell your child not to swallow any toothpaste or water.
• Do not let your child wear contact lenses. Bring your child's glasses or contact lens case.
• Be sure your child has something that reminds him or her of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery center

• A parent or legal guardian must accompany your child.
• Your child will be kept comfortable and safe by the anesthesia provider. Your child will be asleep during the surgery.
• The surgery will take about 1 to 3 hours.
• After surgery, your child will be taken to the recovery room. As your child wakes up, the recovery room staff will monitor his or her condition. The doctor will talk to you about the surgery.
• You will probably be able to take your child home 1 to 2 days after the surgery.
• Your child may have a wire guard across his or her upper lip. This helps prevent the lip from stretching and protects the stitches from breaking or separating. Your child may need to wear this for 10 to 14 days.
• Your child may have splints on his or her arms. The splints keep your child's arms straight so that he or she cannot rub the incision while it heals. Your child may need to wear the splints for several weeks.