ProceduresCleft lip and palate · Maxillofacial

Cleft lip and palate:
treatment in stages

A cleft of the lip or palate is treated by a team and in stages, from the first months until growth is complete. Each surgery has its moment.

Book your consultation→Step by step↓

Lip: Around 3–6 months
Palate: Around the first year
Bone graft: Around 8–10 years
Approach: Multidisciplinary team

Approximate values: every case is different and your plan confirms them at the consultation.

What is a cleft lip and palate?

It is an opening in the lip, the palate or both, which forms during pregnancy when these structures do not fully join. It can affect feeding, speech, hearing and the position of the teeth.

It is not corrected with a single surgery: the plan follows growth. First the lip and palate are repaired; years later, the bone of the gum (alveolar graft); and at the end of growth, if needed, the position of the jaws.

During his specialty at UNAM, Dr. Rodríguez took part in cleft lip and palate surgical campaigns in several Mexican states, and has given lectures on its management.

Who is on the team

01Maxillofacial and plastic surgeryfor the repairs and grafts.
02Orthodonticsto guide the teeth and prepare each stage.
03Speech therapyfor speech after the palate is closed.
04Paediatrics and ENTfor feeding and hearing.

The exact timeline is set by the team for each child.

Stages

Each surgery, at its moment.

Ages are approximate and adjusted to each case.

013–6 months
Lip repair
The lip and its muscle are joined and the shape of the nose is improved.
02Around the first year
Palate repair
The palate is closed and its muscle rebuilt, which is key for speech.
038–10 years
Alveolar bone graft
Bone is placed in the gum cleft before the permanent canine comes in, so it has a path to erupt.
04When growth is complete
Orthognathic surgery
If the upper jaw has stayed behind, it is brought forward to correct the bite and the profile.

Step by step

From diagnosis to adolescence.

01Pregnancy or birth
Diagnosis and plan
A cleft lip is often seen on the ultrasound. The team explains the stages and how to feed the baby.
02First year
Lip and palate
The first two surgeries, under general anesthesia.
03Childhood
Speech and hearing
Speech therapy and hearing check-ups.
048–10 years
Alveolar graft
Bone in the gum cleft, coordinated with the orthodontist.
05Adolescence
Orthodontics and, if needed, orthognathic surgery
When growth is complete, the position of the jaws is finalised.

After the alveolar bone graft

What to expect

Days 1–2
Short hospital stay to control pain and hydration.
Weeks 1–2
Liquid diet; pain improves in the first days.
Weeks 3–6
Soft diet; nothing hard in the mouth.
Month 3
Check-up X-ray with the orthodontist.

Frequently asked

What patients ask before deciding.

A cleft lip is often seen on the ultrasound. An isolated cleft palate is harder to see and is often diagnosed at birth.

It depends on the type of cleft. Typically the lip and palate are repaired in the first year, the bone graft around 8–10 years and, in some cases, orthognathic surgery at the end of growth.

So the permanent canine has bone to come through. It is coordinated with the orthodontist according to how the teeth develop.

The palate takes part in speech; that is why it is repaired around the first year and followed by speech therapy.

Yes. Adult sequelae—missing bone in the gum, missing teeth or an upper jaw that stayed behind—can be assessed for grafts, implants or orthognathic surgery.