Cleft lip repair/revision

Frequently asked questions

Q: What is cleft lip surgery?

A: The cleft of the lip can be unilateral (affecting the right or left) or bilateral (affecting both sides). In the cleft lip operation, incisions (cuts) are made and the separate portions of the lip are brought together to form a single full lip. The repair of the child's lip generally takes place at age 10 to 12 weeks, although the timing of repairs may different from child to child. There are several ways of repairing a cleft lip (also called a cheiloplasty), and the surgeon will choose the type of repair that is best for your child, and depending on the type of cleft lip your child has. As your child grows older, he/she may require an additional operation called a lip revision in order to correct any distortions that may occur in the lip over time.

Q: What should I expect after surgery?

A: Your child will return to his/her room after a short stay in the recovery room. An IV (access line into the vein) will be placed during surgery and will be used to give fluids, medicine for pain, and/or nausea or antibiotics. The nurse will frequently assess your child ‘s pain level using observation and talking to you and your child, and either using the faces pain scale (for younger children) or the verbal pain scale (for older children). She will also decide when your child can eat and/or drink. Once your child is both taking fluids and pain medicine by mouth, the IV can be taken out. It is normal to see some swelling, bruising or drainage (clear to blood-tinged) at the incision site. Again, this is normal and will improve within a week. The stitches will either dissolve on their own or will need to be removed about a week after surgery. Once pain is controlled with pain medicine by mouth, and your child is taking fluids well, discharge is possible. During the week or two following surgery your child can walk or play quietly but should not run, play rough or put anything sharp in their mouth.

Q: How should I feed my child after surgery?

A: Always feed your child in an upright position. Infants and young children will be using the soft tipped syringes for feeding while the older children nay use a cup. No pacifiers, nipples, utensils or straws are allowed for 10 days after surgery since they may injure the surgically repaired site. Formula and liquids are encouraged for 10 days after surgery. After that your child may begin eating soft foods. One month after the date of surgery all diet restrictions are lifted.

Q: Are elbow immobilizers necessary?

A: For infants and young children elbow immobilizers must be worn. They are necessary to prevent your child from accidentally disrupting the surgical repair by accidentally putting either their fingers or objects in their mouth. The immobilizers should be worn at all times for 10 days after surgery. However, they should be removed several times during the day to allow your child to exercise their arms. Skin should also be checked while the immobilizers are off. Look at the skin for any changes in color or size. If you desire lotion may be applied at this time. While the immobilizers are off please supervise your child and prevent them from putting anything in their mouth. When applying the immobilizers, be careful not to put them on too tight. Make sure the fingers and hands are pink and warm, and your child can move them.

Q: How do I care for the lip after surgery?

A: Keeping the lip clean after surgery is important for healing. Immediately after surgery keep the suture line clean and free of scabs and crust. To do so gently cleanse the lip with either mild soapy water or half-strength hydrogen peroxide (half hydrogen peroxide/half water mixture) using a cotton swab/Q-tip. After cleaning the lip apply a thin coat of bacitracin or polysporin ointment (these can be bought over the counter without prescriptions at your local drug store) to the incision using a cotton swab/Q-tip. Clean the lip 3-4 times a day, especially after meals, for 2 weeks after surgery.

At one month from the date of surgery, begin to massage the lip gently with your fingers. As the weeks go by, begin to apply more and firmer pressure using a circular motion and then moving downward. As part of the normal healing process the scar may be red and firm for a period of time after surgery. Massaging the scar helps reduce the amount of scar formation and improve its appearance.

You can use any facial cream that you would like when you begin massage. Massage the lip 3-4 times a day for five minutes each time. This massage should continue for a period of 6-9 months for initial lip repair and 9-12 months for lip revision. It is best to avoid direct sunlight for a minimum of 6 months, as this may make the scar more noticeable. Once this occurs it is more difficult to correct. When outdoors apply sunscreen with a minimum of 30 SPF to the healing scar. If the scar remains thick, firm, red and does not improve with massaging after 2 months, please call and set up an appointment to see our surgeons. Please do not delay as correcting it may be more difficult.

Q: What complications/problems should I look for after surgery?

A: Please contact us if you notice any of the following: A temperature higher than 101°F, drainage that looks like pus or is green/yellow appearing (clear, pink or dark red/ brown are normal), a foul odor, an increase in pain or swelling, or if the incision begins to separate.

Please remember it is important to keep your follow-up/post-operative check-ups with our surgeons. Please make every effort to keep them. If you are unable please call and reschedule as soon as possible by calling 773-385-5410. Call 773-622-5400 with any questions or concerns and ask to speak with either the plastic surgery resident or the plastic surgery nurse.