Approximately 1 in 700 children born have a cleft lip or a cleft palate. An older term is harelip, based on the similarity to the cleft in the lip of a hare. Clefts can also affect other parts of the face, such as the eyes, ears, nose, cheeks, and forehead. Most of the craniofacial clefts are even rarer and are frequently described in medical sciences. A cleft lip can be successfully treated with surgery, especially so if conducted soon after birth or in early childhood.
What is Cleft-lip?
A Cleft lip (cheiloschisis) is a variation of a type of clefting congenital deformity caused by abnormal facial development during gestation. A cleft is a fissure or opening or a gap. It is the non-fusion of the body's natural structures that form before birth. During early pregnancy, separate areas of the face develop individually and then join together, including the left and right sides of the roof of the mouth and lips. However, if some parts do not join properly, sections don't meet and the result is a cleft. If the separation occurs in the upper lip, the child is said to have a cleft lip.
What are the Types of Cleft-lip?
The three common kinds of cleft-lip are:
What are the Problems Associated with Cleft-Lip?
Why Cleft-lip Surgery?
This type of surgery is done to correct a physical defect caused by a cleft lip or cleft palate. It is important to correct these conditions when they cause problems with nursing, feeding, or speech.
How to Prepare for Cleft-lip Surgery?
Facial clefting has a wide range of clinical presentations, ranging from You will meet with a speech therapist or feeding therapist soon after your child is born. The therapist will help you find the best way to feed your child before the surgery. Your child must gain weight and be healthy before surgery. Your child’s surgeon may:
What is the Procedure for Cleft-lip Surgery?
Cleft-lip surgery can be initiated at any age, but optimal results occur when the first operation is performed between two and six months of age. Surgery is usually scheduled during the third month of life. While the patient is under general anesthesia, the anatomical landmarks and incisions are carefully demarcated with methylene blue ink. An Endotracheal tube prevents aspiration of blood. The surgical field is injected with a local anesthetic to provide further numbing and blood vessel constriction (to limit bleeding). Myringotomy (incisions in one or both eardrums) is performed, and Myringotomy tubes are inserted to permit fluid drainage. There are several operative techniques for cleft lip reconstruction. The Millard rotation advancement (R-A) technique is the most widely accepted form of repair. This method involves rotation of the entire philtral dimple (groove in the upper lip) and Cupid's bow (double curve of the upper lip). The scar falls along the new philtral column (central section of the upper lip), and is adjusted as required since the procedure allows for flexibility.
The Millard procedure begins with an incision on the edge of the cleft side of the philtrum, and the cutting continues upward, medially, and to the side. A second incision extends to the buccal sulcus (top part of the upper jaw). The length of this incision depends on the size of the gap to be closed. In this second incision, the surgeon frees soft tissue, which allows him or her to completely lift the lip from the underlying bone. This dissection should be tested to ensure free advancement toward the middle (inadequate dissection is the root cause of poor results). Nasal deformity can be dealt with by a procedure known as the Macomb nasal tip plasty, which elevates the depressed nasal dome and rim. Cartilage from the cleft side is freed from the opposite side, and is positioned and reshaped using nylon sutures. Advantages of the Millard rotation advancement technique include the adaptable and flexible approach with minimal amount of tissue discarded.
What are the Post-Operative Care after Cleft-lip Surgery?
The postoperative focus is on ensuring proper nutrition, as well as lip care and monitoring the activity level. Breast milk or full-strength formula is encouraged immediately after surgery or shortly thereafter. Lip care for patients with sutures should include gentle cleansing of suture lines with cotton swabs and diluted hydrogen peroxide. Liberal application of topical antibiotic ointment several times a day for 10 days is recommended. There will be some scar contracture, redness, and firmness of the area for four to six weeks after surgery. Parents should gently massage the area, and avoid sunlight until the scar heals. The patient's activities may be limited. Some surgeons use elbow immobilizers to minimize the risk of accidental injury to the lip. Immobilizers should be removed several times a day in a supervised setting, allowing the child to move the restricted limb(s). Interaction between the orthodontist and surgeon as part of the treatment team begins in the neonatal period, and continues through the phases of mixed dentition.
How is the Recovery after Cleft-lip Surgery?
Your child may be restless for awhile after surgery, but your doctor can prescribe medication to 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. Your doctor will advise you 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.
What are the Benefits of Cleft-lip Surgery?
The team approach to correcting Cleft Lip and other problems associated with it has several fold benefits. Symmetry or balance of facial features is restored to a great extent but not completely. The surgeons have mastered sophisticated techniques that have improved the success rate of surgery for Cleft Lip many fold. If the surgery to repair Cleft Lip is performed in the first year of life, chances are that ability to feed properly, talk, facial growth and development of social skills will be less problematic in the years to come.
What are the Risks of Cleft-lip Surgery?
There may be excessive scarring and contraction of the lips. Whereas the lips in most cases remain red in the initial stage but thus the redness and contracture is part of the normal healing process
Why Cleft-lip Surgery in India?
Cleft-lip Surgery in India has come out to be the best option for international patients since most of them desire a budget saving and good medical treatment. The Indian medical centers have team of professional and specialist who have a passion for the science of medical treatment in India and are known for good results.
Cleft-lip Surgery in India comes with advanced cosmetic protocols and is delivered using modern facilities, sterile techniques and products meeting international standards which are designed for comfort and efficiency as evident in developed nations through expert cosmetic care to foreign patients.
Cleft-lip Surgery in India is done at medical centers that are equipped with high end medical amenities. These medical centres adheres all the international benchmark and maintains a high standard as practiced in developed nations of US and UK. The hospitals catering the procedures of Cleft-lip surgery are available in the following Indian cities:
The above is only a partial list of the criteria that your surgeon will consider in determining whether or not this procedure is appropriate for you. Be sure to discuss the procedure thoroughly with your doctor prior to the procedure.
Liposuction Surgery Areas:
Liposuction can be performed in following areas of the body:
Liposuction Surgery Preparation:
Your surgeon will discuss how to prepare for your operation.
Types of Liposuction Surgery Procedure:
There are various procedures for doing liposuction. Liposuction patients should be aware of the various types of liposuction that are currently available so they can make an educated decision when choosing their surgeon and treatment plan.
What is the Cost of Cleft-lip Surgery in India?
Cost advantage is a major selling point for Cleft-lip Surgery in India. The cost differential across the board is huge: only a tenth and sometimes even a sixteenth of the cost in the West. Thus this plays a vital role in attracting a sea of foreign patients all across the world to India. The following figure indicates the cost of certain treatments in US and India, which can give you a fair idea of the cost difference.
USA (in USD)
India (in USD)
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