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Cleft lip & Palate Surgery :- management
of cleft lip & palate starts right after birth. cleft lip
& palate are not individual problems but are constellation
of so many components some of which can be managed
non-surgically in early days after birth and these early
small maneuvers help a lot n reconstructive surgery later
on and have great impact on final cosmetic appearance of
baby.
Deformities with Cleft Lip &
Palate:- As such cleft lip deformities can be broadly
grouped under three headings - cleft lip; cleft
palate & cleft lip nose deformity.
Cleft Lip Can be - Unilateral
Complete Cleft Lip -
Unilateral Complete Cleft Lip with
Cleft of Anterior Jaw ( Alveolar cleft )- Before After
picture
Unilateral ( One Sided)
Incomplete Cleft Lip -
Unilateral Incomplete Cleft Lip with
Nose Deformity - Before after picture
Bilateral Cleft Lip -
Bilateral Cleft Lip- Before After
Cleft Lip Repair surgery Picture
Cleft palate - Cleft palate
associated with Cleft Lip
Bilateral Cleft Lip and Palate -
Cleft of Posterior Palate - Before After Cleft Lip &
Palate Repair Picture
Cleft in lip ( Discontinuity of Skin
,Muscle & Mucosa); short vertical and horizontal dimension
of lip tissue on cleft side, cleft of gingiva (gum) with
involvement of tooth buds; underdeveloped maxilla ( upper
jaw bone) on cleft side; cleft in floor of nose; deformity
of nostril and ala of nose, Deviation of nose, deviation
of nasal septum; drooping tip of nose; cleft in palate;
Discontinuity of muscles in soft palate which control
speech & swallowing.
Management protocol for cleft lip &
palate patients:- i ) soon after birth alveolar molding is
started to align alveolar arch ( upper jaw) and simple
traction devices to reduce cleft dimension. these can be
used by parents at home after consultation with a plastic
surgeon.
ii) Cleft lip surgery is done at age
of three years.
iii) cleft palate surgery is done
between age of 9 months to one year.
iv) Speech Assessment at age of 2.5
years and if needed speech therapy or revision
intravelar veloplasty ( soft palate surgery) to improve
speech which is usually hyper nasal in these patients.
v) Alveolar arch expansion:- with
orthodontic devices, at age of 6 years
vi) alveolar Bone Grafting :- 7-9
years, bone from pelvis ( waist bone) grafted to alveolar
arch ( upper jaw) so that bone will become continue , will
provide platform for eruption of tooth and support base of
nose.
vii) cleft Rhinoplasty:- for
correction of cleft lip nose deformity, done once child
has crossed age of facial bone maturity , i.e. after 12
years in females and 14-15 years in males. for details
visit our "Rhinoplasty " page.
for information on cleft lip nose
deformity correction you may visit my research work
in research & publication page.
Lip augmentation with Filler or Fat for Thin Lips :
Thin lips usually give tired and exhausted look while full and protruding lip
look more healthy and sexy. Thin lips are augmented with fillers or autogenous
fat to give more full appearance.
Lip augmentation with autogenous fat graft before after picture.
Lip fat injection can also be used to correct asymmetry of lips as well.
Lip augmentation & asymmetry correction with fat injection
Double Lip / Thick Lip Reduction Surgery :-
Double Lip is a variant of occult ( Hidden ) Cleft lip,
occurs due to mal -alignment of muscles acting on lip.
Correction needs both removal of excess
fibro-fatty-vascular tissue as well as restoration of
normal lip muscle orientation and frenum lengthening.
Double Lip or Thick Upper Lip Correction Before After picture
Thick Lower lip often , is due to small
receded chin which alters axis of pull of muscles
and leads to Everson of mucosa, so correction
involves both Lip reduction, Chin Enlargement or
Augmentation and correction of orientation of
muscles.
This is important in plastic & Cosmetic Surgery to
understand the reason behind any problem, Simplest
treatment may not be the optimal treatment always.
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