CLEFT LIP AND PALATE Posted in: Reconstructive Surgery

The Cleft Lip and Palate Surgery, is one that corrects deformities of the palate, upper lip and nose. These deformities are present at birth and are caused by an alteration of the anatomy and function on these structures during the embryonary period.

These changes are by definition familiar congenital and hereditary.

Not everyone that is born with cleft lip or palate, i.e. “harelip”, must necessarily engender a similar case in their offspring, but there is a possibility of 8%, i.e. a very remote one. In addition, if a person is born with any of these defects, it does not necessarily mean that their parents, Mom and Dad, had these defects. It can even appear for the first time in a very long line in your family tree, even if no cases have appeared a single time.

No one knows the exact cause of Cleft Lip When a combination of genes and environmental factors cause a disorder, the inheritance is called “multifactorial” (many factors contribute to the cause). Because of their genetic information, the chances of repeating a cleft lip or palate in a family is increased, depending on how many clefts have presented in that family. If parents do not suffer from cleft lip or cleft palate and have a baby with these disorders, the likelihood that these are repeated in another baby range from 2 to 8 percent. If one parent has a cleft, but neither of their children presents this anomaly, the odds of having a baby with a cleft are from 4 to 6 percent. If one parent and a child have a cleft, the chance for another child with this anomaly is even greater.

See these possibilities with a genetic specialist.

Several predisposing factors are known to produce a case of lip and palate in a pregnant woman, including:

* Radiation such as X-rays and some others, in the first trimester of pregnancy
 * Ingestion of corticosteroids, or derivatives of cortisone, also in the 1st.
Pregnancy period.
*Some substances isolated as medicines to prevent nausea and  vomiting, etc..
* Some nutritional deficiencies.

It should be noted that there is absolutely no connection with astrological phenomena and climate. It is common in our population with limited knowledge to have beliefs in this regard.

The Cleft Lip and Palate Surgery in Mexico, is performed by three
specialists:

* Plastic Surgeons
* Pediatric Surgeons
* Maxillofacial Surgeons

The goal of these surgeries is to functionally reconstruct all of the features affected by nature, such as: speech and word pronunciation; swallowing food; closing the mouth, pursing the lips and avoiding “whistle deformity”.

CLEFT LIP SURGERY

There are two types of cleft lip or cleft palate: Unilateral and Bilateral (One side or both sides). Each type can be incomplete (half-way through) or   complete (all-the-way-through).

The greater deformity, the greater difficulty in surgical closing, and technical details that require touch-ups or subsequent surgery. In correcting those imperfections a lot of time and surgeries might come to scene.

Surgery is performed under general anesthesia, and for this to be performed, we have a rule: we call the rule of the 10’s:

The baby should at least:

· Have more than 10 weeks of age,
· Weigh over 10 kilos
· Have more than 10 grams of hemoglobin, which is the substance that  carries oxygen in blood to be carried to the tissues.

It is a surgery that takes about 45 minutes, and is one of the most ingenious and creative that can exist in plastic reconstructive surgery, and is another example where the boundary between the aesthetic and reconstructive surgery is intimately interposed with one another. Please click Plastic Surgery as an Art .

When it comes to a healthy adult who has left untouched this deformity for adult life, it can be operated under local anesthesia and sedation.

CLEFT PALATE SURGERY

There are three types of cleft palate, as in the case of the lip: Unilateral and Bilateral (One side or both sides). Each type can be incomplete (half-way through) or   complete (all-the-way-through).

As in the case of Cleft Lip, the greater deformity and elapsed time since birth, the greater difficulty in getting a fine, plastic closure.

The aim of this surgery is to functionally reconstruct all features involved, namely: ability to suck the breast, swallowing food, and later on, speech and word pronunciation.

It is a delicate operation and meticulous, and should be done under general anesthesia. The ideal age for surgery, differ by multiple groups of specialists dedicated to these deformities, and is usually accepted to operate from 3 to 6 months of age.

 CLEFT NOSE SURGERY

Correcting the nose of a Cleft Lip after initial surgery is a secondary need in some cases of moderate to severe cleft lip and palate cases, since the nose is always involved in such babies. Usually in the first lip surgery, we also work in the cartilages and soft parts of the nose to leave a nose with a more aesthetic and symmetrical tip and nostrils. However, it is common to have to do a definitive work upon reaching adolescence, when dimensions of the face stop growing and it is possible to do major plastic surgery.

Next, I present before and after recommendations for these operations:

BEFORE SURGERY:

Do not take aspirin or aspirin products for 2 to 3 weeks; click Non-Recommended Medicines for more details. Wash with Isodine (US: Betadine) foam the body part that is going to be operated very well once a day for three consecutive days before operation. Do not drink any water let alone eat meals or snacks from 12 the night before surgery. Do not wear makeup the day of surgery, or nail polish, false eyelashes and earrings, metal necklaces, rings, etc. Wear comfortable clothes and shoes. If you get common cold, call the office before.

If your son or daughter is the one I am going to operate, apply these directions to him or her.

AFTER SURGERY:

Go straight home and stay in bed for 24 to 48 hours. You can get up to the bathroom and three meals. If you don’t have discomfort or nausea, you can eat normally.

Avoid the sun, hot meals, hot baths or warm places for a week.

Put crushed ice into a bag and wear it on the cheeks, without touching the lip surgery, 15 minutes every 4 hours. Usually patients do not complain of any pain, but if it happens, take your pain medication as indicated. You can have a hot tub bath until I indicate so.

Do not expose yourself to trauma, don’t touch yourself or let the patient touch the lip surgery. Take your medicine as indicated. You cannot drink alcohol during this treatment. Typically you are asked to come back to the office to the 3rd and 7th days and thereafter every 7 to 15 days.

I usually leave the arms splinted in extension; that way they do not touch the operation.

If it is your child’s surgery, and if you’re going to take care of him or her at home, give her/him this care and I will gladly support you over the phone in any questions, day or night, at my cell phone: (664) 283-0976 or the office: (619) 730-1917 or (664) 684-2551.

If the child is operated on the palate, treatment is even stricter: you must eat with a spoon or dropper, slowly and carefully. There may be slight bleeding and this is normal, but if more than one small handkerchief completely wet, you should call the office or my cell phone. It must not be given to eat crunchy or hard foods like nachos, irritating or extremely hot foods.

To see some photographs of these cases, click Photo Gallery.

Any doubts about this surgery, please call the office, 684-2551  (US: 619-730-1917) or my cell 664-283-0976. We wish you a speedy recovery and an excellent experience with your esthetic lid surgery, send an email or click Contact us for more information

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