bilateral cleft lip, before and 3 months after cleft lip repair

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These babies are usually managed by a team of specialist which include,

Plastic Surgeon.
Otolaryngologist .
Dental surgeon.
Speech therapist.
Specialist nurse.
Social worker.

Cleft lip can be repaired as early as at 2 months so long as the baby is otherwise healthy and at a certain weight (around 4-5 kg). Repair of the cleft palate will be between 6 months to 1 year of age. This is so that the speech development and hearing will not be impaired. Some of the babies with cleft palate might require grommet insertion to drain fluids in the middle ear. This will be done at the same time as  the palate repair by the otolaryngologist. The other surgical procedure for cleft patients are,

Timetable of surgical repair in the cleft patient 

Lip repair and alarplasty at 3 months.

Palatoplasty at 6-12 months.

Pharyngoplasty at 6-12 years.

Lip scar revision 2 years and above.

Alveolar bone grafts and closure of oro-nasal fistula 11-14 years.

Rhinoplasty 18 years and above.

Orthognathic surgery 18 years and above.

Cleft of the lip can be divided into either unilateral or bilateral clefts and it can either be incomplete or complete. They can present with or without a cleft of the palate. A cleft palate that does not have a cleft lip is termed as a secondary cleft palate. Babies with cleft lip and palate requires specialise treatment in hospital as they will have problems with feeding, speech, hearing and social issues if the cleft are not repaired.


A cleft lip and palate is a abnormal gap that is present at birth in the upper lip, upper gums (alveolus) and palate. It is more common in Asians as compared to caucasian being present in 1 in 500 live births. Baby boys are more commonly affected than baby girls and cleft of the left side of the lip is more common than the right. In about 70% of babies born with clefts the exact cause is unknown although various factors such as smoking, maternal malnutrition, infection and environmental pollutants have been implicated. In the other 30% of babies with a cleft a congenital cause can be found. Cleft lip and palate is associated with syndromic conditions such as Down's, Edward's and Treacher Collins.