Research > Cleft Lip and Palate

Cost of Cleft Palate Surgery

Cleft lip and palate surgery is considered reconstructive surgery to correct a birth defect, so it typically is covered by health insurance. However, pre-insurance costs for surgery can range from several hundred to several thousand dollars. Parents of a cleft palate patient should discuss these costs with their specific insurer.

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Benefits of Cleft Lip Surgery and Cleft Palate Surgery

A cleft lip and palate can greatly alter facial appearance, and severely inhibit a child’s ability to eat and speak. Ear infections and dental problems are also very common. Cleft lip and palate surgery can correct these problems to improve the current and future health of the patient. If the surgery is postponed until late in the first year of life, a prosthetic device may be temporarily necessary; this device would artificially close the palate so the baby can feed and grow as he/she awaits the surgery date.

How is cleft palate surgery performed?

Cleft palate or cleft lip surgery is performed in the hospital under general anesthesia. When repairing the palate, the surgeon connects the soft palate muscles from each side and creates a normal barrier between the mouth and nose. Typically, a child remains in the hospital for two nights. For some patients, additional surgeries (such as alveolar bone graft, which closes the gap in the bone or gums near the front teeth) may be needed between six and 10 years of age as dental development progresses.

Cleft Lip and Palate Surgery Recovery

Following surgery, some temporary changes in feeding, positioning, and activity are necessary. Infants should not suck on a nipple, bottle, or pacifier for 10 days after surgery; instead, the surgeon will provide a special post-operative feeding syringe, which contains a short piece of soft, rubber tubing. Experts recommend that parents help the child “practice” drinking from the syringe before surgery. Children over one year of age may also drink from a cup. Your child’s surgical team will provide more specific instructions on a feeding timeline.

Most children are kept on an IV for a period following surgery (again, the length of time varies by surgeon). Please follow your surgeon’s sleeping instructions; normally, it is recommended that a child who has had a cleft lip repair to be positioned on his/her side or back only. It is important to keep the stitches clean; parents are shown how to clean the suture line and apply ointment while in the hospital. The stitches are normally removed one week after surgery.

To keep the child from hurting the incision or putting hands or toys in his/her mouth, many surgeons prescribe gentle arm restraints to keep them from bending their elbows for the first 10 days.

Risks of Cleft Palate Surgery

Qualified plastic surgeons with experience in repairing cleft lip or palate normally report successful procedures and results. However, all parents should be aware of potential risks and complications that have occurred in a small number of cases.

In cleft lip surgery, asymmetry (when one side of the mouth and nose does not match the other) is the most common complication. Additionally, there is a risk of scar formation, as incisions are necessary to accomplish the goal of the surgery. Surgeons attempt to keep scars to a minimum and place them in locations where they will be least apparent. In cleft palate surgery, separation of the palate repair can occur secondary to feeding trauma, infection, or surgical tension on the repair. If this occurs, a second surgery will be necessary.

In about 10 percent of cases, speech development may be abnormal and necessitate secondary surgery.

Who is the ideal candidate for cleft lip and palate surgery?

Ideal candidates for cleft lip and palate surgery are infants who reveal a cleft at birth. Most experts concur that the minimum age for cleft palate surgery is six weeks. Ideally, most patients should undergo the surgery prior to the first birthday.