Pediatric Cleft and Craniofacial Anomalies Center

Cleft Lip Surgery

Cleft lip is one of the most common and one of the most correctable birth defects. Surgery is required to close the gap in the upper lip.

Before

Our skilled plastic surgeon and the surgical team at Golisano Children's Hospital will do its best to ensure your child's comfort and safety, as well as your peace of mind during the procedure. Often, it helps to know what to expect following surgery.

What to Expect

General

  • For a week or two after surgery, your child may need extra attention and understanding. Don’t worry about “spoiling” your child during this time. It is OK to respond to your child’s need for extra holding and comforting.
  • After surgery, your child will be sleepy for several hours. Your child will have an IV in place for giving fluids and pain medicines. Some children will have soft plastic tubes called stents in the nose. These stents maintain the shape of the nose while it heals. The lip and nose will be swollen. You may see a little bloody drainage around the lips and nose. You will see stitches on the lip and under the nose, and they will be covered in ointment.

Cleft lip surgery pre-opFeeding

  • Your child’s lip is repaired with a combination of dissolving and permanent sutures that will need to be removed, but the repair is delicate for several months after surgery.
    • Give your child his or her usual diet at home.
    • Avoid pressure on the lip stitches with the nipple or feeder.
    • If you are breastfeeding, your child may breastfeed the evening of the operation. You can also use a soft-tip spoon, sippy cup or bottle. Do not give your child a pacifier.
  • Sometimes your child's nose may get stuffy. This will make it difficult for your child to eat. Clear the nose with normal saline nose drops. You can buy saline nose drops in any drug store. If the nose drops don't clear your child's nose, use a nasal aspirator or bulb syringe. This must be done very gently.

Activity

  • For 2 weeks, dress your child in the special Velcro® sleeves you received.
    • Remove the sleeves several times a day to exercise your child's arms. Take off only one sleeve at a time, so that your child will not be able to touch the lip.
    • When the sleeves are off, be sure to make sure your child does not touch the suture line.
    • Do not give your child a pacifier.
  • Generally, most children are ready to return to daycare about 2 weeks after surgery. If you have concerns or questions about when your child can return, discuss with Dr. Morrison.

Pain

  • Your child may have some mild discomfort at home. If your infant is irritable and not feeding well, he or she may be in pain. Give acetaminophen (Tylenol®), as directed by your child’s doctor. Acetaminophen comes as a tablet, caplet, and liquid. It is used to relieve mild to moderate pain and to reduce fever. It is important to take acetaminophen exactly as directed by your doctor. Follow the directions on the package and ask your doctor or pharmacist to explain any part you do not understand. Do not take more or less of it than prescribed by your doctor. Do not take it any more often than prescribed by your doctor.
  • If your child has more than mild discomfort, the doctor may prescribe medicine to help ease the pain. Give pain medicine as prescribed and instructed by your doctor and nurse.
  • Try to schedule a dose of pain medicine around bedtime, especially for the first few days at home. This will help your child sleep better.

Constipation

  • Keep track of your child’s bowel habits. He or she should return to previous bowel habits. If not, he or she may be constipated.
    • Call your child’s pediatrician or Dr. Morrison if you think your child is constipated.

Skin and Wound Care

  • The incision is closed with a combination of absorbable sutures that won’t need to be removed, and permanent sutures that will need to be removed about 1 week after surgery. Please ensure you have follow-up scheduled with Dr. Morrison within 5-7 days of surgery to remove the sutures.
  • The nose and lower edge of the lip should be gently cleaned in the morning and in the evening each day. It is best to keep the incision line as clean as possible with no crusting. You may clean with a wet cotton swab (Q-tip®) and water. You may loosen any crusts in the nose with saline nose drops. After the area is cleaned, apply a thin layer of bacitracin over the sutures for the first 5 days after surgery. After 5 days, you may use petroleum ointment (Vaseline or similar) to keep the wound moist.
  • The nose may be supported by a soft silicone rubber stent, which is sutured in place inside the nostrils. The goal is to keep this in place for up to 3 to 6 weeks. Please do not attempt to remove the silicone stent – it will be removed by Dr. Morrison in clinic. The holes in the nostril stents should be irrigated twice each day with a small amount of saline or salt water to keep the passage open. You can buy saline nose drops in any drug store.
  • You can bathe your child in the tub. The lip can get wet, but do not wash the area.

Cleft lip surgery post-opFollow-up

  • Your child will be seen in the office 5-7 days after surgery for suture removal.
  • After this visit, you will likely be seen again in about 2 months.
  • When to call your child’s doctor or nurse
  • If your child:
    • has redness, increased swelling, drainage, or bleeding from the lip incision
    • has separation of the suture line
    • has a fever higher than 101.5°F degrees (taken under the arm)
    • has pain that doesn't get better after pain medicine is given
    • is not drinking liquids or is vomiting
    • has trouble breathing

Back to Cleft and Craniofacial Center home page

Connect with Golisano Children's Hospital

Golisano Children's Hospital Development

Contact Us

To contact the Pediatric Cleft and Craniofacial Center or a team member, please call (585) 273-FACE.

Have a question for a member of the Pediatric Cleft and Craniofacial team?
Send us an email!