By Bahar Ozbal • Medical review by Onder Tan, MD on February 04, 2021

Review 1
Average Cost 12000
Treatment Genel Anestezi
Recovery Time 1-2 Hafta
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118 - All Doctors
ClinicExpert
Medical Aesthetician
Aylin Bilgin Karabulut, MD
Plastic, Reconstructive and Aesthetic Surgery
Onder Tan, MD
Plastic, Reconstructive and Aesthetic Surgery
Ebru Sen, MD
Plastic, Reconstructive and Aesthetic Surgery
Emre Guvercin, MD
Plastic, Reconstructive and Aesthetic Surgery
Gulden Avci Cakmak, MD
Plastic, Reconstructive and Aesthetic Surgery
Burak Sercan Ercin, MD
Plastic, Reconstructive and Aesthetic Surgery
Lutfi Tekes, MD
Plastic, Reconstructive and Aesthetic Surgery
Reviews

What is Cleft Lip and Palate?

Cleft lip and palate is one of the congenital anomalies that occur during the development of the fetus in the womb. Between the 4-7th weeks of the pregnancy process, the structure that forms the lip is expected to unite. A cleft lip is observed in a situation that occurs due to the defect of non-fusion of this structure.

Generally, in 50% of all cleft cases, cleft lip and palate are seen together, while in 25% only cleft lip, 25% only cleft palate is seen.

However, in Turkey and in general in one of every 1,000 live births in the world lip & palate or isolated cleft lip observed, isolated cleft palate occurs in one of every 2,500 live births. Lip & palate or isolated lip clefts are more common in boys, and isolated cleft palate is more common in girls due to genetic factors.

Everything You Need To Know About Cleft Lip And Palate

Lip and palate cleft surgeries are performed in private hospitals between 7,000 TL and 20,000 TL on average. Factors such as the chosen plastic and aesthetic surgeon, hospital, province-district where the surgery will be performed, and hospital are effective on pricing.

Some of the expenses for cleft lip and palate surgery are covered by the SGK within the scope of congenital anomalies. Orthodontic treatments and aesthetic applications are excluded.
Performing cleft lip surgeries at the earliest age that the child's general body development and tissues will allow surgery and leave a minimum scar (at the end of the 3rd month); It is ideal for cleft palate surgeries to be waited long enough not to affect facial development, but to be performed before starting to speak (between 12-18 months) due to the negative effect of the cleft on speech functions.
The two most important criteria in both surgeries are that the baby's development and weight have reached normal limits on the first day of surgery compared to their peers, and the second is not having any infection, especially the upper respiratory tract.

A healthy diet is also essential for normal growth and weight required for surgery. Cleft lip and palate requires a new planning regarding the feeding of the baby. In babies diagnosed with cleft lip and / or cleft palate, sucking function will be insufficient in the feeding process; The baby should be breastfed in a 45 degree half-sitting position on the lap, if there is a problem in breastfeeding, it should be fed with a cheeky or special bottles.

Because the integrity of the lip and palate anatomy of babies with cleft lip and palate is impaired, the functions of sucking and creating negative pressure inside the mouth are incomplete, which leads to feeding problems. Intraoral obturators (occluders) designed by dentists who are specially interested in cleft treatment can help.
Cleft lip and palate surgeries are performed by a multidisciplinary team under general anesthesia in a hospital environment using special surgical tools and suture materials.
The duration of the operation takes an average of 1.5-3 hours depending on the size of the incision and the scope of the surgery to be performed.
In cleft lip surgery;
  • The cleft is closed by repairing the muscle, skin and lip mucosa in three layers separately.
  • If there are gaps in the inner part of the lip, extending into the nose, it is closed,
  • The opening in the base of the nose is closed,
  • If there are clefts in areas such as teeth, gums, dental beds, these areas are also repaired during surgery.
  • In some techniques, the deformed nose is also corrected with the cleft lip in the same session (Triangular with Ala Nasi, TAN II repair).
Cleft palate surgery is performed using a special mouth opener. Generally, it is completed in a single session and rarely in a double session. The cleft line is closed by bringing the existing palate tissues on both sides to the midline. A palate of sufficient length is created for proper speech and swallowing.

During this procedure, if the hard palate is cleft (complete), it is formed in two separate layers as mouth and nasal mucosa; Soft palate cleft (incomplete and complete) is repaired in 3 separate layers by repairing additionally the muscles effective in speech. This muscle repair (intravelar veloplasty) is as important as closing the cleft in the palate for the recovery of speech functions.
In cleft lip and palate surgeries, stitches are not taken as the preferred stitches will usually be self-melting stitches. The lip area is covered with special skin bands (sterile-strip) and a dressing is applied. If necessary, small tampons can be placed in the nose.
Intra-palate bleeding is controlled with a cellulose dressing after cleft palate surgery.


Rarely after lip surgery, but occasionally after palate surgeries, the baby may experience breathing problems with the palate closing.
In such a case, for the safety of the airway, the baby may need to be monitored in intensive care for one or a few days and respiratory support. In standard clinical follow-ups, where this is not the case, one or two nights of hospitalization is given after cleft lip and palate surgery.
In this process, the baby is supported with intravenous nutrition, and the distress associated with the surgery is alleviated with painkillers. After you leave the hospital, you will be relieved by painkillers that will be recommended by your doctor for a few days.

In addition, it will be recommended to apply additional antibiotics and steam therapy to postoperative pain relievers.
It is necessary to keep the suture and stitch area hygienic after the operation and not to insert fingers into the operation areas and mouth. Therefore, after the surgery, the baby will need to wear gloves and special arm sleeves that prevent bending of the elbows will need to be used.

In the first weeks following the surgery, it is necessary to pay attention to the program and nutrition style recommended by your doctor on issues such as how the baby will be fed, what should be paid attention to, and what to do for adequate fluid intake.

After cleft palate surgery, the baby should be fed on a lap and with a spoon. Care should be taken to keep the mouth wound area clean by drinking water after each meal. Liquid nutrition is anticipated for an average of 2-6 weeks. After cleft lip surgery, liquid nutrition can begin at the end of 1-2 days following the surgery. A clear diet is applied before the transition to liquid nutrition, which is anticipated in both surgeries.
Intraoral incisions are expected to be healed by the end of the first week.
While the scars inside the mouth are not visible after palate surgery, it is inevitable to have a reasonable surgical scar (scar) after lip cleft surgery.

Under magnification, with a meticulous surgical technique and minimal damage to tissues, it is possible to minimize scar and achieve optimum results by using special and very fine suture materials.

Lip and palate clefts are accompanied by a special, highly deformed and difficult to treat nasal structure called "cleft lip-nose deformity (cleft lip nosei, CLN)".

Traditionally, the nose is not touched during cleft lip surgery and nasal deformations can be corrected by aesthetic rhinoplasty after the person completes the facial development (17-18 years), this approach cannot correct the deformity that has become very severe and its success is limited, it requires a second surgery and it is too long. Because of the handicaps such as condemning the child to live with a cleft nasal deformity for a while, methods that corrected the nose simultaneously with the cleft lip became more and more popular (Triangular with Ala Nasi, TAN II repair).
Thus, with the logic of "tree bends at age", nasal cartilages can be shaped when they are very fresh, nasal deformity can be corrected at a very early age, the need for aesthetic rhinoplasty either completely disappears in the future or the chance of success increases with a simple procedure, and the child is not forced to live with nasal deformity for a long time.
Cleft lip and palate is a problem that should be treated as soon as possible after birth. Since there is an early intervention for cleft lip and palate that negatively affects the quality of life in many areas from nutrition to speech, it should be followed and treated with specialist physicians in different fields.

Cleft lip and palate; Treatment and follow-up processes should be planned by a multidisciplinary team consisting of newborn, genetics, pediatrics, otorhinolaryngology, aesthetic and plastic surgery, orthodontics, speech therapists and dentists.

For this reason, there is a team selection, not a doctor selection. Post-multiple consultation surgeries must be performed by a plastic surgeon experienced in cleft lip and palate. It is ideal to continue the treatment process with the same surgeon and team.
97% of cleft lip and palate are multifactorial, that is, genetic and environmental factors encountered by the fetus in the womb during pregnancy (smoking, alcohol, drug use, vitamin A and B group deficiency, radiation, especially viral infections such as rubella (rubella), etc.); the remaining 3% is of syndromic origin (genetic or teratological syndromes, chromosomal abnormalities).
Cleft palate and cleft lip; Problems of not combining the structure that make up the palate and lip may occur suddenly.

  • Unilateral Cleft Lip - Incomplete (incomplete) / Complete (Complete)
  • Double Sided Cleft Lip - Incomplete (incomplete) / Complete (complete)
  • Cleft Palate - Incomplete (Incomplete) / Complete (Complete)

Lip clefts may be in the form of a slight notch (incomplete, incomplete), as well as (complete, complete) lip clefts extending to the nose and even palate.

Written on 15/05/2017

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Last Update: 22/04/2021

Doctors & Clinics
118 - All Doctors
ClinicExpert
Medical Aesthetician
Aylin Bilgin Karabulut, MD
Plastic, Reconstructive and Aesthetic Surgery
Onder Tan, MD
Plastic, Reconstructive and Aesthetic Surgery
Ebru Sen, MD
Plastic, Reconstructive and Aesthetic Surgery
Emre Guvercin, MD
Plastic, Reconstructive and Aesthetic Surgery
Gulden Avci Cakmak, MD
Plastic, Reconstructive and Aesthetic Surgery
Burak Sercan Ercin, MD
Plastic, Reconstructive and Aesthetic Surgery
Lutfi Tekes, MD
Plastic, Reconstructive and Aesthetic Surgery

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My doctor was very profesypnel and approached positively. I trusted him very much. I had a cleft lip and palate surgery. I...

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118 Cleft Lip Treatment Doctor
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