Cleft Lip Adhesion and Cleft Lip Repair
The first lip surgery is typically timed around 3 months of age. It might be later if doing NAM or if your child needs more time to grow before having surgery. If the cleft is wide or a bilateral, then a two-staged approach is recommended for the best aesthetic result. The first stage is called a cleft lip adhesion, and the two sides are brought together, with some initial work on reconstructing the nose. There is tension on this closure, which will improve during the healing process. The second stage is then performed approximately 6-9 months later at the time of the cleft palate repair. This is the formal repair, which realigns the lip for the best symmetry and because this closure is under less tension, the scar and cosmetic outcome will be improved.
A soft silicone nostril splint (called a Koken Nostril Conformer) is often placed to help shape and support the nostril on the cleft side. Revisions can be performed if necessary in the future.