Cleft Lip and Cleft Palate Repair
by Rebecca J. Stahl, MA
Cleft lip and cleft palate repair are surgeries of the lip and the roof of the mouth. These repairs are 2 separate surgeries that are sometimes done together.
Surgery is usually done at a young age. Cleft lip repairs occurs most often at age 3 to 6 months. Cleft palate repairs occurs most often at age 9 to18 months.
Reasons for Procedure
These surgeries are done to repair birth defects called cleft lip and cleft palate. A cleft lip is an open gap in the upper lip. A cleft palate is an open gap in the roof of the mouth. If left untreated, the child can have many complications, such as:
The goals of cleft lip repair are to:
The goal of cleft palate repair is to have the palate area function normally. This includes proper development of the teeth and jaw, as well as speech.
Problems from the procedure are rare, but all procedures have some risk. Your child's doctor will review potential problems, like:
Additional birth defects may put your child at a higher risk for complications.
Be sure to discuss these risks with the doctor before the surgeries.
What to Expect
Prior to Procedures
Your child will need to have an empty stomach before surgery. Make sure you get specific instructions about when to stop feeding your child.
In the time leading up to the surgeries, the doctor may have your child wear a device called an obturator. The device fits inside the mouth. It may help your child during feedings and help to keep the arch in the lip.
Your child will be treated by a team of specialists. The doctors will:
General anesthesia will be used. It will block any pain and keep your child asleep through the surgeries. It is given by IV.
Description of the Procedures
Cleft Lip Repair
To repair a cleft lip, an incision will be made on either side of the cleft. The incision will be from the lip to the nostril. Sutures will be used to close the 2 parts of the lip. If your child has 2 openings on either side of the lip, an additional surgery will be needed in about a month. Bandages will be placed over the incision area.
Cleft Palate Repair
During cleft palate repair, incisions will be made on the 2 sides of the cleft. A special flap technique will be used to move the hard palate in the front of the mouth and the soft palate in the back of the mouth. The muscle fibers in the palate will also be moved. Removable or absorbable stitches will be used to close the area.
Immediately After Procedures
Your child will be brought into the recovery room. The hospital staff will monitor your child’s vital signs. In some cases, oxygen may be given through the nose.
How Long Will It Take?
How Much Will It Hurt?
Anesthesia prevents pain during surgery. Your child will be given medication to relieve pain or soreness during recovery.
Average Hospital Stay
The surgeries are usually done in a hospital. For a cleft lip repair, your child may have to stay overnight. A longer stay may be required if an additional cleft repair is planned. If your child is having cleft palate repair, the hospital stay is usually 2 to 3 days.
At the Hospital
The hospital staff will:
During your child's stay, the hospital staff will also take steps to reduce the chance of infection such as:
There are also steps you can take to reduce your child's chance of infection such as:
To help ensure a smooth recovery for your child at home:
After the surgeries, you will see scars at the upper lip and nose. These scars will fade with time. After the repairs are done, your child will be able to develop and function normally. In some cases, your child may need more surgeries to improve appearance. Surgeries may also be needed to improve breathing problems, jaw alignment, or speech development.
Call Your Child’s Doctor
It is important to monitor your child's recovery. Alert your child's doctor to any problems. If any of the following occur, call your child's doctor:
Call for emergency medical services or go to the emergency room right away for:
If you think your child has an emergency, call for emergency medical services right away.
Centers for Disease Control and Prevention
National Institute of Dental and Craniofacial Research
Birth Defect Research for Children
Cleft lip and cleft palate surgery. American Society of Plastic Surgeons website. Available at: https://www.plasticsurgery.org/reconstructive-procedures/cleft-lip-and-palate-repair. Accessed September 5, 2019.
Cleft lip and palate. Kids Health—Nemours Foundation website. Available at:
...(Click grey area to select URL)
Updated October 2014. Accessed September 5, 2019.
Rosen H, Barrios LM, Reinisch JF, Macgill K, Meara JG. Outpatient cleft lip repair. Plast Reconstr Surg. 2003;112(2):381-387.
What to expect: cleft lip surgery. University of Missouri Children’s Hospital, Pediatric Plastic Surgery website. Available at: https://www.muhealth.org/conditions-treatments/pediatrics/pediatric-plastic-surgery/cleft-lip-and-palate. Accessed September 5, 2019.
Last reviewed September 2019 by EBSCO Medical Review Board Donald W. Buck II, MD
Last Updated: 9/16/2020