Finding out your unborn baby or newborn child has been diagnosed with a cleft lip and/or a cleft palate can be an intimidating time. You know that surgery will be in your child’s future, but may wonder what’s the best technique and what’s the best timeline? And, just how many corrective surgeries will your child need to address his or her diagnosis?

Craniofacial surgeons Dr. Langevin and Dr. Cone are parents themselves. They understand the concerns related to a cleft lip and cleft palate diagnosis from both a parent and a physician’s perspective. While each cleft presentation is unique, meaning there’s no one-size-fits-all answer for every cleft, our surgeons are here to keep you best informed and help you make a customized treatment plan that meets the specific needs of your child.

Cleft lip/palate First Visit

Cleft lips are addressed on children in early infancy. We prefer to meet parents prior to delivery when possible to outline a treatment plan and then visit with the parents and infant within the first few days of delivery.  In the first 1-2 weeks we can start molding the lip, the nose, and/or the dental ridge (aka the alveolus). Doing so prepares the child’s lip, nose and dental ridge for an optimal surgical repair.

Cleft Lip Surgery and ENT Evaluation at 3-4 Months of Age

Around the time your child has turned 3 or 4 months of age, he or she will be ready for his or her first surgical procedure. This surgery focuses on repairing the cleft lip, and is one of the most transformative for the child.  Our surgeons often say that few experiences in the world are as rewarding as watching parents see their child for the first time with a repaired cleft lip. In addition to the transformation in appearance, the lip repair creates significant improvement in lip function which helps with eating and breathing.  In some cases of cleft lip and palate, Dr. Cone and Dr. Langevin may also be able to address the soft palate during this surgery, too.

Because children with cleft lips often also exhibit frequent ear infections and ear fluid build-up, he or she will also be evaluated by one of the ENTs we collaborate with to determine if ear tubes need to be placed, too. This relatively quick surgical procedure can help prevent painful, recurrent ear infections and even hearing loss.

Cleft Palate Repair at 9-11 Months of Age

Sometime shortly before your child’s 1st birthday, surgery will be scheduled to repair his or her cleft palate. We typically wait until children are about a year of age for this surgery in order to allow the bone of the palate to grow sufficiently and to give them the best opportunity to develop normal speech. Additionally, addressing a cleft palate earlier than 1 year may result in the child developing impaired facial growth.

Potential Surgeries Around 2 Years of Age

Once your child is around 3-4 and is talking up a storm, we’ll begin collaborating with you to determine how his or her speech is developing.  Speech is a learning process for all children (if you’ve tried to understand someone else’s 3 year old, you’ve seen the challenge and how the parents can understand the child but others do not). Children with cleft palate have these same challenges, but can have additional challenges with “P” & “K” sounds.  As many as half of all children with a cleft palate benefit from speech therapy. Additionally, 15% of children who’ve had cleft lip and palate repair may require additional surgery to address scar tissue which may be interfering with their speech.

A cleft lip and palate can also affect a child’s gum ridge. This can result in misplaced teeth or teeth that don’t develop where they’re supposed to. If your child exhibits these symptoms, he or she will be considered for follow-up surgery to treat this issue around age 2. For all of these reasons, we follow our patients yearly, monitoring their progress and customizing a care plan as needed.

Potential Surgeries During the Teenage Years

Many families don’t realize that the repair of a cleft lip and palate can at times extend into the teen years. A small percentage of patients may display midface retrusion or midface hypoplasia. These conditions can make this midface appear underdeveloped, flat, or misaligned. Combined with orthodontic treatment, an additional craniofacial surgery may be required to correct this issue in the teenage years. Additionally, the teenage years can be a good time to address any remaining differences or asymmetries in the nose through a cleft rhinoplasty. Surgery is usually performed after they have finished developing, which is usually around ages 15-17 for female patients and ages 16-18 for male patients.

We’re With You Every Step of the Journey

As you can see, correcting this diagnosis is a journey, not an event. But don’t worry. Our practice will be here with you every step of the way.

If you have additional questions about the potential surgeries your child may need, or have just received a diagnosis and are looking for a craniofacial surgeon to partner with, call our office today at (512) 600-2888.