Cleft lip and cleft palate are two of the most common physical malformations in infants and young children. Although these conditions are not life threatening, the problems they cause often are distressing for parents. Plastic surgery can relieve both the problems caused by the malformation and the resultant distress.
What It Is
Two plates in the skull normally come together during gestation to form the entirety of the hard palate of the face, but sometimes these plates do not fuse. The result is a visible gap that includes both the hard and soft palates. Cleft lip occurs when the muscular structures around the hard and soft palates do not close properly but the palates themselves are intact. It is thought that cleft lip/palate is primarily genetic in nature. But other factors may be involved, according to the University of Maryland Medical Center.
Reasons for Plastic Surgery as Treatment
Improved Speech Development
Closed palates and lips are necessary in order for a baby to produce the sounds he hears. But if these structures are open, the baby cannot form the correct mouth shape or position the tongue accurately for sound production. Plastic surgery for cleft lip and palate thus allows a baby to avoid language delays.
Improved Feeding
Children with cleft lip/palate often have a hard time nursing, drinking from a bottle, or eating with a utensil because they cannot use the palate structure or lip muscles to form a good suction or bring food off of the breast, bottle, or utensil, according to University of Maryland Medical Center. When the cleft is corrected through surgery, the infant is less frustrated at feeding times and is able to get adequate nutrition with less effort and less mess.
Lessened Social Stigma
Those with physical deformities unfortunately tend to be viewed as less intelligent or as having less desirability or importance. And some people even view those with deformities as being deserving of those conditions. Children with cleft lip or cleft palate are often stared at or ridiculed, which can erode self-esteem and make it difficult for the child to develop or to maintain relationships. Surgery can help the child feel like he is not ugly, isolated, or worthless—it can help him to feel “normal.”
When Surgery Can Be Done
Surgery for cleft lip and cleft palate usually is done at 2 to 3 months of age. This is only an average, as other factors (such infant illness, travel, insurance problems, etc.) can affect the ability to operate.
How Many Surgeries Are Needed
The number of plastic surgeries needed to correct cleft palate or cleft lip depends on the severity of the problem. In cases where the cleft is bilateral (the gap is on both sides of the palate), two surgeries usually are necessary instead of one.
After Surgery Care
Care after surgery can continue for up to 10 years. The Cleft Palate Foundation child usually is followed by an entire team that can monitor both physical and linguistic progress. However, the initial recovery time is fairly short, with major improvement seen after as little as a month and scarring fading over time.
Insurance Considerations
Some insurance companies will not cover plastic surgery for cleft lip and cleft palate because the conditions usually are not severe enough to threaten the life of the child. The procedure is considered purely cosmetic in such cases, especially since other treatments such as the use of a prosthetic to close the gap exist. Fortunately, most insurance companies recognize the physical limitations that the conditions cause and therefore cover some, if not all, of the cost.
Assessment
If your child has a cleft lip or cleft palate and you think surgery may be the best option of treatment, have your child assessed by a professional. They can tell you how severe the condition is and what to expect from the care team over the course of surgery and treatment, and they can help explain to your child (if older) what is going to happen to him in a way that makes the child feel safe through the treatment.
