Number of surgeries needed to correct different types of cleft lip

The number and type of surgery used to correct a cleft lip depends on how much of the lip is involved, whether it occurs with cleft palate, and whether the nose is affected.

Surgery for a child with an isolated cleft lip (not occurring with cleft palate) may require:

• A single surgery if the cleft is small and affects only one area of the lip (unilateral).
• Two surgeries, if it is a wide unilateral cleft. The first surgery on the lip usually is done as soon as possible (generally when the baby is between a few days to 6 weeks old). The second surgery on the lip usually is done when the baby is about 2 to 3 months old.
• Two surgeries for a cleft affecting two areas of the lip (bilateral). Each area is usually surgically repaired in separate procedures.

The type of surgery needed for a child with a cleft lip and/or other related deformities depends on the specific combination of problems.

• A child with cleft lip and a defect of the nose usually needs two surgeries. However, some doctors prefer to correct the nose defect during the same surgery to correct the cleft lip; they believe that this will cause fewer problems with speech later in life. Other doctors prefer to wait until the child is 5 or 6 years old, believing that waiting avoids problems with uneven facial growth because the nose grows more slowly than the rest of the face.
• A child with a cleft lip and a cleft palate may need two or more surgeries.
• Additional surgeries may be needed to correct any unevenness of the lip line or scars that formed on the lips from previous surgery. These surgeries may be done as late as the teen years.