Cleft lip with or without cleft palate occurs in about 1 out of 700 live births. The condition may affect either the right side, the left side, or both sides. The cleft may either be complete (the full vertical height of the lip) or incomplete. In most cases of cleft lip, there is an associated cleft of the palate. The cleft may cause difficulties with feeding, speech, breathing, dentition, and growth.
Are you unhappy with the results of your cosmetic nose surgery? This happens to about 15 percent of all nose surgery patients. Nose surgery can deliver great results, but in some cases, they are not achieved through the initial procedure. Many patients who undergo nose reshaping surgery decide to undergo a second procedure to further enhance the shape, size, or width of the nose. Cleft Lip Repair can also be performed to help patients who are experiencing difficulty breathing as a result of the initial procedure.
The repair of the lip is typically performed approximately 3 months following the child’s birth. The repair of the lip is also associated with an aggressive repair of the cleft nasal deformity. Dr. Sundine routinely uses nasal splints postoperatively to reduce scar contracture that may affect the appearance of the nose. One week postoperatively the patient is returned to the operating room for a brief suture removal under anesthesia.
Dr. Sundine is also considered an expert for cleft lip repair revisions, for children, teenagers, and adults. People come from out of the state, as well as out of the country, for their specific expertise in this procedure. Some of the reasons for the need for revision of cleft lip repairs include: under rotation of the cleft repair, malalignment of the lip, the fullness of the lip, or a whistling deformity (notch in the free border of the lip). Oftentimes young teenagers and adults seek out Dr. Sundine to repair these deformities and to help them gain the confidence they need to move forward with their career goals, school goals, and in general, feel better about themselves. These repairs are typically performed on an outpatient basis. The exact treatment necessary is dependent on the deformity seen.
You may feed your child normally (ie. using a cross-cut nipple, Haberman feeder, pigeon nipple, etc.). You will be given a prescription for Tylenol® with codeine elixir for pain. You may use this medication every six hours as needed for pain. You may also use plain children’s Tylenol® liquid for pain.
Apply bacitracin ointment to the lip suture lines four times daily.
Keep the “No-No’s” in place at all times for three (3) weeks following the operation. The “No- No’s” may be removed for bathing.
Keep the nostril retainers in place at all times for six (6) months following the operation. The purpose of the nostril retainers is to try to keep the cleft side nostril open during the early wound healing period.
The nostril retainer may become occluded with nasal crusts. The nostril retainer may be removed and cleaned using a Q-tip and some tap water. Replace the nostril retainer into the nose and hold it in place with paper tape or 1⁄2” Steri-strips with holes punched out for the nostrils (use a standard paper hole punch).
At one week postoperatively from the lip repair your child will return to the operating room for removal of the lip sutures under anesthesia. REMEMBER TO NOT FEED THE CHILD FOR 8 HOURS BEFORE THE SUTURE REMOVAL!!!
Continue the bacitracin ointment to the suture line four (4) times daily for another week.
At two weeks postoperatively from the initial lip repair, you will return to the office for a postoperative follow-up visit. You will be instructed on how to perform the massage of the lip scars at that time.
*Call our office if you have any questions, if any problems should arise, or if you have been having any signs or symptoms of infection (redness, fever, drainage).
Dr. Sundine is a member of the Cleft/Craniofacial Team at the Children’s Hospital of Orange County and works with the other members of the team to ensure the optimal outcome for patients with cleft lip. Dr. Sundine is considered an expert in this field and has both a national and international prescience because of his expertise and skill in this and other facial aesthetic procedures.
