Where to Begin
Cleft Lip Anatomy
Orbicularis muscle fibers run horizontally within the lip, turning upward to parallel the margins of the cleft. On the cleft side in unilateral clefts, the fibers insert into the base of the columella and the alar base, respectively. In bilateral clefts, the muscle fibers insert into the alar bases without any fibers reaching the central prolabial segment.
Cleft Palate Anatomy
Planning for Surgery
At your initial consultation we will discuss the details of the procedure that will be used, including where the surgery will be performed, the type of anesthesia to be used, possible risks and complications, recovery, costs, and, most of all, the results you can expect. We will also answer any questions you may have about feeding your baby, by breast or by bottle, both before and after the surgery.
Most repairs are done at about 12 weeks of age. This allows the appearance of any birth-related illness to be noted and treated, the child to gain weight and establish a reasonable hematocrit. This is frequently referred to as the "Rule of 10s" (10 weeks old, weight of 10 pounds and 10 grams of hemoglobin). Repair before age one is generally thought to produce the least visible scar. In some cases, a preliminary "lip adhesion" may be required in excessively wide cleft lips to reduce the strain on the lip repair and reduce the risk of wound dehiscence. This will provide a remodeling of the alveolar arch and reduce the tension in the repair at the time of definitive lip repair some months later. The use of presurgical orthodontic molding appliances has virtually eliminated the need for lip adhesion in our patients.
In most cases, health insurance policies will cover most or all of the cost of cleft lip or cleft palate surgery. Check your policy to make sure your child is covered and to see if there are any limitations of coverage. Our office staff can offer assistance and recommendations in these matters.
