A cleft lip can range in severity from a slight notch in the red part of the upper lip to a complete separation of the lip extending into the nose. Clefts can occur on one or both sides of the upper lip. Surgery is generally done when the child is about 10 weeks old.

To repair a cleft lip, an incision is made on either side of the cleft from the mouth into the nostril. The dark pink outer portion of the cleft down will be turned down and the muscle and the skin of the lip pulled together to close the separation. Muscle function and the normal "cupid's bow" shape of the mouth are restored. The nostril deformity often associated with cleft lip may also be improved at the time of lip repair or in a later surgery.

Your child may be restless for a while after surgery, but medication can be prescribed relieve any discomfort. Elbow restraints may be necessary for a few weeks to prevent your baby from rubbing the stitched area. If dressings have been used, they'll be removed within a day or two, and the stitches will either dissolve or be removed within five days. You will be advised on how to feed your child during the first few weeks after surgery.

It's normal for the surgical scar to appear to get bigger and redder for a few weeks after surgery. This will gradually fade, although the scar will never totally disappear. In many children, however, it's barely noticeable because of the shadows formed by the nose and upper lip.

Perhaps most important, keep in mind that surgery to repair a cleft lip or palate is only the beginning of the process. Family support is critical for your child. Love and understanding will help him or her grow up with a sense of self-esteem that extends beyond the physical defect.

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