Cleft Lip Repair (Cheiloplasty)

Preparation

Most cleft lips are repaired between 3-6 months of age depending on the size of your baby, the type of cleft and the type of pre-surgical treatment recommended, such as the naso-alveolar molding. You will have a pre-op visit with the surgeon a couple of weeks before the surgery date to discuss the final plans of surgery.

Surgery

This is usually an outpatient procedure (unless otherwise indicated by the surgeon) and your child may go home with you the same day after surgery.

  1. The Surgeon will meet with you before and after surgery. When your child’s vital signs (blood pressure, heart rate and temperature) are stable, you will be called into the Recovery Room to hold and feed your baby.
  2. Discharge from the recovery area will occur once your baby is drinking from the bottle, and has urinated. This may be 1-2 hours after surgery is over.
  3. Restraints (“no-no’s”) will be placed on your child’s arms to prevent bending of the arm close enough to touch the tender area with hands or toys. These restraints can be removed under CLOSE supervision for bathing and exercise. They should be kept on for about a week or longer if your child tends to put their fingers or other various objects in the mouth.

At-Home Care

  1. Feeding: Nipple feeding is permissible after cleft lip surgery. However, you should not let your baby put anything into the mouth that might cause injury (like a pacifier or fingers) for 2 weeks after surgery. If your child is still taking a nipple, you can use the same nipple and formula as before surgery.
  2. Dehydration may occur and it is important to recognize the following signs: decrease in number of wet diapers, dry mouth, decrease/absence of tears, thirst, less elasticity in the skin, eyes and fontanel (baby’s soft spot on head) appear sunken, irritability or sleepiness. If any of these symptoms occur, please call the clinic immediately to determine if you need to go to the emergency room for intervention.
  3. Pain Management: A prescription of Tylenol with Codeine might be given for pain before discharge from the hospital. After a day or two with Tylenol with Codeine, switch to Infant’s Tylenol (ask your pediatrician for dosing). If no prescription medication is given, use Infant’s acetaminophen (Tylenol), which is available at your local drug store. If your child has excessive pain or a temperature of 101 0 F or higher when you return home, please call the office or your pediatrician immediately.
  4.  Stitches/Sutures: All sutures are absorbable/dissolvable and should not have to be removed. There may be some stitches visible beneath the nose but the skin of the lip will be held together with skin glue, called Dermabond. There are many sutures beneath the skin that you can not see. Please keep the incision clean by using baby’s bath soap and water. The scar often stays red for up to six months. Sometimes the scar may also pull the lip up slightly. The surgeon will tell you when to begin massaging the scar to soften it up. If the incision turns red, drains fluid or feels hot to the touch, please call the office immediately.
  5. Recovery/Healing: Swelling does occur and may be worse the second day. It may extend up under the baby’s eye and may partially close the baby’s nose. Swelling will usually decrease after three to five days but slight swelling remains for a few weeks. It is not unusual for babies to be fretful and have sleep and feeding patterns disrupted for several days after surgery.
  6. Nasal Stents: depending on your type of lip repair, your baby might have nasal stents in place. Our team should have given you verbal and written instructions on how to care for them at home, as well as supplies. You can remove & clean the nasal stents as early as 24hrs after surgery. Please be mindful of the stents as they are easy to lose. The stents will be upsized once a month for the next 3 months in clinic.
  7. Before leaving the hospital, it is highly encouraged that you get your child’s pain medication filled at the pharmacy (only if it is recommended for your child). There is a Walgreen’s connected by a skybridge to the hospital. They are located in the Hermann Professional Building (6400 Fannin). Doing so ensures that you will have pain medication in a timely manner. If you have any issues receiving the medication, please call the office immediately.

Post-Op Visit

The day you are released from the hospital, please call the office to schedule your post-op appointment for 7-10 days after being released. If there are any other medical concerns, please call the office at (832) 325-7234. If you are calling after office hours, please leave a message with the answering service and we will return your call as soon as we can.