Find A Surgeon

What is cleft lip repair and cleft palate repair surgery?

Cleft lip and cleft palate are common birth defects affecting children globally. These conditions, characterized by incomplete formation of the upper lip or roof of the mouth, can occur individually or together and vary in severity. Surgical intervention is necessary to address them.

The cleft, an incomplete formation of the upper lip and/or roof of the mouth, occurs early in foetal development. While certain syndromes can contribute to its occurrence, for most children, the cause remains unknown and is believed to involve a combination of genetic and environmental factors.

Timely intervention by a multidisciplinary team is crucial to evaluate and manage treatment for cleft lip and/or cleft palate. This is a collaborative effort coordinated by a clinical nurse specialist. Many specialties may be involved: plastic surgery, paediatrics, dentistry, orthodontics, otolaryngology, audiology, speech-language therapy, genetics, and psychology. Initially, the focus is on feeding, growth, and development, with specialized feeding techniques often required due to challenges in creating oral suction, particularly when a cleft palate is present.

What does cleft lip and cleft palate surgery involve?

Cleft lip and cleft palate repair operations aim to correct abnormal development, restore function to the lips and mouth, and improve appearance. Surgery is typically performed using specialized plastic surgery techniques, these procedures are highly individualized.

Cleft lip repair involves:

  • Closing the cleft to create a scar within or near the upper lip
  • Forming a cupid’s bow
  • Establishing an improved relationship between the upper lip and nose

Additional procedures may be recommended to address nasal symmetry and nostril shape.

Cleft palate repair focuses on:

  • Closing the defect to separate mouth and nasal function
  • Restoring soft palate muscle function for speech
  • Reestablishing normal relationships between the soft palate, auditory canal, and Eustachian tube for hearing
  • Promoting growth of the upper jaw and teeth
  • Addressing defects in the gumline to facilitate permanent tooth eruption

When should my child have surgery?

The timing of cleft repairs depends on individual circumstances:

  • Cleft lip repairs are typically performed between 3 and 6 months of age.
  • Cleft palate repairs usually follow, between 9 and 15 months of age.
  • Surgery may be delayed to address other health issues (including seasonal viral infections), local team protocols, or hospital capacity.
  • Pre-operative interventions or staged surgery techniques may be recommended based on cleft severity.
  • Additional surgeries, such as grommet insertion or bone grafting, may be necessary over time.

What should I expect during a consultation for cleft lip and cleft palate repair?

During the consultation, you’ll discuss:

  • Your child’s condition and your concerns
  • Surgical options and likely outcomes
  • Risks and complications associated with the procedure
  • Recommended treatment plan

Open communication and adherence to your plastic surgeon’s instructions are essential for the success and safety of your child’s procedure. Be forthcoming about your concerns and your child’s health history to ensure the best possible outcome.

What questions should I ask my plastic surgeon about Cleft Lip & Palate surgery?

  • Are you vocationally registered with the Medical Council of New Zealand as a specialist plastic surgeon?

  • Are you a member of the New Zealand Association of Plastic Surgeons?

  • Will the procedure be conducted in a hospital or office-based setting, and is the facility accredited for this type of surgery?

  • What type of anaesthesia is needed for this procedure?

  • Based on my medical history and condition, is surgery the best option for me? If so, am I a suitable candidate for this surgery?

  • Which surgical technique do you recommend for my case, and why?

  • What are the realistic expectations for the outcome of this procedure in my case?

  • What steps or lifestyle changes are necessary for me to get the best result from my surgery?

  • What is the anticipated duration of recovery, and what assistance will I need during this period?

  • What potential risks and complications are associated with this procedure? How would you manage these should they arise?

  • How will my results change over time?

  • If I’m unhappy with the outcome, what recourse options are available?

Kirk Williams

Sarah Gardiner

Tristan de Chalain

Craig MacKinnon

Jonathan Wheeler