Understanding Cleft Lip and Cleft Palate Repair

Overview
A cleft lip or cleft palate is a birth defect that occurs quite frequently in newborns from all cultures. Cleft lip, medically defined as cheiloschisis, is one of the most common birth defects in children born in North America. Cleft palate, known as palatoschisis is a condition that results from an incomplete formation of the roof of the mouth, while a cleft lip is an incomplete formation of the upper lip. Children may be born with one or both of these conditions, which may also differ in severity.

In most cases, cleft lip and cleft palate are repaired through cosmetic surgical procedures to correct the deformity. This repair requires special surgical techniques. In most cases, contrary to other types of cosmetic and plastic surgery procedures, most health insurance plans do cover repair of cleft palate and cleft lips in most scenarios but insurance cap limits and exclusions may apply.

Common Cleft Lip and Cleft Palate Repair Techniques
Cleft palate repair is not specifically designed to close defects, but to ensure that children are able to function in a normal manner, as well as to enhance appearance. In many cases involving a cleft palate, considerations for surgery may include but not be limited to resolve lip and jaw alignment, speech development, and repair defects that affect hearing. Cleft lips may also distort the shape of the nose, eating ability and speech processes.

In most cases, and whenever possible, cleft lip and cleft palate repair generally occurs when children are between nine and 18 months of age. However, some repairs can be performed when a child reaches at least 10 pounds, or is at least 10 to 12 weeks of age. A pediatrician, pediatric dentist, or ear nose and throat specialist will assess a child's condition and evaluate the condition and will refer to a cosmetic or plastic surgeon who will decide which approach is most beneficial.

Repair of a cleft palate involves repositioning muscles and tissues to close the cleft, or division in the roof of the mouth. Incisions on each side of the cleft and tissue flap techniques are used to reconstruct both the soft and hard portions of the roof of the mouth and then stitched closed. In either the case of a cleft palate or cleft lip repair, incisions are often closed with absorbable sutures. Parents should realize that in many cases, treatment and surgery of cleft palates may occur over years of a child's development, from toddlerhood, early childhood, through adolescence and into adulthood.

Benefits from Cleft Lip and Cleft Palate Repair
In addition to enhancing and improving feeding, eating, speech and hearing, repair of cleft lip and cleft palates offer children a sense of confidence and well-being. Scarring from cleft lip repairs today are minimal and offer children who undergo such procedures the benefits of a normal appearance less likely to produce stares and questions from peers. Many children born with cleft lips and palates are extremely self-conscious about their appearance and procedures that repair such defects provide enormous emotional and mental improvement.

Cost of Cleft Lip and Cleft Palate Repair
Cost of cleft lip and cleft palate repair in the United States are often covered by medical insurance plans, and depending on the amount of deductible and limits to insurance, individuals may still be left with astronomical medical bills. For those without medical insurance, cleft lip and cleft palate repair may range an average of $20,000, depending on technique and severity of the cleft lip or cleft palate. Over the lifetime of a child who must undergo multiple surgeries, costs may rise to tens if not hundreds of thousands of dollars for additional surgical treatments as the child grows. Cleft palate repair in India costs an average of $2,550, and again may vary depending on severity of the defect. Cleft palate and lip repairs in Latin America may save international travelers between 30% and 75% of the costs charged in the United States and Britain.

Choosing a Surgeon
Any type of cleft lip or cleft palate repair should be performed by a surgeon who is trained and experienced in plastic and cosmetic facial surgeries. Ensure that any physician that engages in such procedures in America belongs to the American Society of Plastic Surgeons, or if Canadian, to the Royal College of Physicians and Surgeons of Canada. In addition, providers in locations such as Mexico, India, Thailand or elsewhere should belong to domestic societies or organizations and associations of plastic and cosmetic surgery in their place of origin. Facilities should be certified and accredited by domestic or international accreditation organizations such as the JCI (Joint Commissions International) or other such accreditation organizations.