Dr. Simona C. Arcan, Oral and Maxillofacial Surgery, 16511 Goldenwest Street #109, Huntington Beach, CA 92647 (714) 847-9000 www.arcanoralsurgery.com

Cleft lip (cheiloschisis) and cleft palate (palatoschisis) (colloquially known as harelip), which can also occur together as cleft lip and palate, are variations of a type of clefting congenital deformity caused by abnormal facial development during gestation. Note that harelip is now considered as a derogatory term. A cleft is a fissure or opening—a gap. It is the non-fusion of the body's natural structures that form before birth.

Clefts can also affect other parts of the face, such as the eyes, ears, nose, cheeks and forehead. In 1976, Dr. Paul Tessier described fifteen lines of cleft. These craniofacial clefts are rare and are frequently described as Tessier clefts using the numerical locator devised by Dr. Tessier.

A cleft lip or palate can be successfully treated with surgery soon after birth. Cleft lips or palates occur in somewhere between one in 600-800 births. click here for full article

Cleft lip and cleft palate surgery
Early in the prenatal development of a child, the right and left sides of the lip and the roof of the mouth (palate) normally grow together. In about one of every 800 babies, these sections do not quite meet, producing what is call a cleft lip or cleft palate. Since both places develop separately, it is possible to have a defect on the lip, palate, or both. Today, with the advances in surgical procedures, there is much that can be done to help a child with these conditions.

Cleft lip surgery
Cleft lips can range in severity from a slight indent in the lip to a complete separation of the lip extending to the nose. Clefts can occur on one or both sides of the upper lip. Surgery is generally done when a child is 10 weeks old. Surgical and recovery time depend on the severity of the defect. In general, after the surgery, the doctor will prescribe medication to relieve discomfort. Usually this is only needed for a couple of days. Pre- and post-surgical care and feeding will be carefully reviewed with the child’s caregiver before and after the surgery. For the first few weeks after the surgery, the wound will appear redder and bigger, but this will fade after time. The scar may never completely disappear, but is often barely noticeable in the shadow of the nose.

Cleft palate surgery
Cleft palates may only involve a small portion of the back palate, or it may involve the whole roof of the mouth from back to front. Depending on the severity of the defect, surgery may be extensive and is usually not done on children until they are nine to 18 months old. After the surgery, the child is usually placed on intravenous fluids (in the hospital) for a few days to maintain fluid levels and discomfort is controlled by medication. The doctor will advise caregivers on care and feeding of the child for the first few weeks after the surgery to assure proper healing.

It is important to remember that surgery may be only part of the total care of a child with a cleft lip and/or palate. In some cases other surgeries may be needed to refine the shape and function of the area as the child grows. Also, other professionals such as a speech therapist, dentist, and/or pediatrician may need to be involved to provide care for the child’s best overall development . Fortunately with good medical care and attentive caregivers, much can be done to assure that children with cleft lips and palates can live a normal, happy, healthy life.