Nasal deformities associated with a congenital cleft lip are a very complex problem and poses significant functional problems as well as aesthetic issues. The cleft lip and nose surgery remain one of the most challenging procedures in reconstructive surgery, particularly when the cleft lips accompany nasal deformity. The surgery is part of Rhinoplasty and it can occur as a birth defect or due to injury or accident.
When there is a cut in the lip that does not involve nasal correction, the reconstruction performed in children and teens is for improving the look of the face. However, when there is a requirement for nose correction also, the procedure becomes more complicated, as the procedure should not affect the growth of the nasal tissues. The knowledge of a surgeon in rhinoplasty can be the keystone for correcting CLND or cleft lip and nose deformity.
Four basic techniques related to rhinoplasty viz., onlay grafting, cartilage transection, suturing methods, reorientation and cartilage repositioning can help the plastic surgeon to overcome the inherent problems related to the patients. The surgeon may choose to apply intravenous sedation and general anesthesia for your child before carrying out the surgery.
The plastic surgeon will make the incision on both the side of the cleft to create flaps of skin, muscle, and intraoral tissue. These are drawn together to make a stitch to recreate a perfect lip and nose anatomy. After repairing the cleft tip and nose, the doctor closes the incision with absorbable sutures.
Preparation before the surgery:
You need to begin preparing your child two weeks before the procedure and should stop administering any medications like aspirin, as these medicines may cause bleeding after the operation. The surgeon or a nurse may call you to check the health history of your child a week before surgery. The day before the surgery, you will get information about the time of surgery and food and drink instructions.
Your child may continue to have breast milk up to 4 hours before the surgery and you must stop providing all other solid and semi-liquid foods. Also, your child may consume clear liquids like water, white grape juice or apple juice two hours before the surgery. The doctor or the nurse may want to know whether your child is having any contagious disease and anything about the health before the surgery so that the doctor can take due care about it.
There can be some amount of pain to your child after the surgery and there can be a small amount of blood in the saliva for several days. Also, there can be more clear drainage coming from the nose for several weeks due to the closure of the nose and mouth. It may be also harder for your child to sleep after surgery and the sleep habit can become normal after several weeks.
Since the appetite of your child will not be good after surgery, your child must drink enough water to stay hydrated. All the discomforts of your child can go away with pain medication recommended by the surgeon and healing will continue till the swelling resolves for several weeks. Lip scars will fade away after several months and you need to ensure to have diligent sun protection to prevent irregular scar formation.
The outcome of the cleft lip and nose reconstruction surgery can help to improve the quality of life of your child that includes the ability to speak, eat and breathe. There may be a requirement for undertaking secondary procedures for functional reasons or refining appearance.
We at Contours Plastic & Aesthetic Surgery Center (www.contourshyd.com), provide world-class service to the patients needing any type of cosmetic surgery or plastic surgery. We have an expert team of doctors to carry out the complex cleft lip and nose reconstruction surgery. Our dedicated team knows how to handle the latest equipment in our clinic and provide the best service to the clients.
The cost of the surgery may vary depending on the complexity of the case and the choice of clinic and on average it can be anything between INR 1, 50,000 to INR 2, 50,000.
Environment and genetic factors can play an important role in causing cleft. The main cause remains the deficiency of folic acid during pregnancy and among the other causes nutritional deficiency, radiation, alcohol consumption, smoking, tobacco chewing, etc during pregnancy are important.
The functional requirements always precede aesthetic corrections and for this reason, there can be a requirement for several surgeries as the child grows up.
There will be swelling in the lip region and it will take time for the disappearance of the red scar. It will take around 6 to 12 months for getting a pleasant look.
? The child needs to be in the hospital for a period of 2 to 3 days.
Normally the clinics allow the parents to stay along with the child and detail instruction for this is available in a clinic.
Breastfeeding or nursing bottle is best for feeding the child in case of an incomplete split. The child will be for 6 hours fasting before the surgery.
Normally, the child can start speaking well after the surgery and in case there is a problem the child needs to undergo speech therapy.
Children get insecure when they see the depression of the parents and there can be irritability and lethargy in the child. Parents should have a frank discussion with their children and provide enough mental support to them.
If it is due to genetic predisposition, there is a high chance of giving birth to another cleft.
You can ask any question to the team of experts and surgeons for clarifying your doubts about cleft.