Cleft lip surgery
Key points below
What is a cleft lip?
Cleft means divided or split. A cleft lip is a divided or split area in the lip. A cleft lip occurs when the lip tissue does not completely close as a baby develops in the womb. A cleft lip does not cause pain for the baby. The doctor may use these words to describe the cleft lip:
- Incomplete cleft lip. The cleft involves the lip and may go part way up to the nose.
- Complete cleft lip. The cleft involves the lip and goes into the nostril.
- Unilateral cleft lip. The cleft is on one side.
- Bilateral cleft lip. The cleft is on both sides.
Surgery to repair a cleft lip is normally done once the baby is at least 10 weeks of age and weighs at least 10 pounds. If the baby was born prematurely or has other health problems, surgery may be delayed. The plastic surgeon will suggest the best time for your baby to have surgery.
What happens before surgery?
- Call your child’s surgeon or nurse if your child is sick before the surgery, or if you have any questions.
How is it done?
- The surgery will take about 1½ to 2½ hours. The surgeon will come to the surgery waiting room to talk with you after the surgery is finished.
- The lip tissue is carefully rearranged, connected, and closed with stitches.
What happens after surgery?
- Your child will stay in the hospital for 1 to 2 nights. Parents can stay overnight with their child.
- Your child may have some discomfort for a few days after the surgery. Tylenol may be given for pain.
- Your child will have an I.V. in the hospital. This keeps your child from getting dehydrated. The IV can also be used to give your child medicines.
- There will be a line of stitches on your child's lip. The lip and face may be swollen for several days. You may see a small amount of bleeding from the stitch line and the nose. Your child will look different, so it is normal for you to have mixed feelings as a parent.
- Soft elbow immobilizers will be put on your child’s arms after surgery. They keep the elbows from bending. This will protect the repaired area from being touched. Your child must wear the immobilizers 24 hours a day for about 2 to 3 weeks. They may only be taken off one at a time to give your child a bath or to exercise the arms.
Watch your child closely when the immobilizers are off. It may be hard to keep them on, but the repair must be protected so it can heal properly.
What care is needed after surgery?
For dissolving stitches
Keep the incision clean and dry. You may gently clean it with a moistened cotton-tipped applicator or wash cloth. Then pat dry. It is ok to bathe your child. Follow the instructions given by your child’s surgeon.
For stitches that need to be removed
- While in the hospital, the nurse will clean the incision. A mixture of 1/2 hydrogen peroxide and ½ tap water is used. An antibiotic ointment may be put on after cleaning. You may need to continue this care at home. The nurse will teach you how to do the lip cleaning before your child goes home from the hospital. Follow the directions given by your child’s surgeon.
- The stitches will be removed in the operating room 4 to 6 days after surgery. The child will be given light sedation for the removal of the stitches. Small strips of tape called Steri-Strips® or a short term glue may be put over the repair to give it support during the healing process. The hospital staff will teach you how to replace these tapes as needed and give you written instructions.
What home care is needed?
- After surgery, your child can be fed using the same method as before surgery. Breastfed babies may continue to nurse.
- The doctor may write a prescription for a liquid antibiotic. Give this to your child as directed.
- If your child is in pain, you may give acetaminophen (Tylenol®).
- Use elbow immobilizers as you are shown for two or three weeks as directed by the surgeon.
- Some children become fussy or crabby after going home from the hospital. They may have problems eating or sleeping. This is normal and should end within a week or two.
Follow Up
Make an appointment to see your child's doctor about 1 to 2 weeks after the stitches are removed.