Cleft Lip and Palate Surgery
Asan Medical Center has performed over 7,000 cleft lip and palate surgeries since initiating the program in 1989, with recent years averaging over 300 cases annually. The surgical goals are to restore normal appearance and function by aligning the muscles and tissues to support optimal feeding, speech, and facial growth. Surgeons make precise incisions along defined anatomical lines, carefully preserving key structures, such as the white roll of the lip, to achieve a natural result. For palate repair, surgeons use multi-layered techniques to close the gap and reconstruct the muscles and lining, using dissolvable sutures. Additional interventions, such as bone grafting in the gum or jaw reshaping, may be performed as the child grows. Comprehensive care extends beyond surgery, providing coordinated dental, speech, and psychosocial support to promote ongoing development
At Asan Medical Center, our Cleft Lip and Palate Program offers a comprehensive, long-term treatment pathway that begins even before birth and continues into adulthood. Our mission is to restore function and appearance through staged surgical interventions, interdisciplinary collaboration, and personalized patient support.
What is Cleft Lip and Palate?
Cleft lip and/or cleft palate is a congenital condition where the upper lip and/or the roof of the mouth (palate) fail to fuse properly during early pregnancy, before the 12th week of gestation. The cleft may extend to the nose and gum (alveolus), creating an opening known as an alveolar cleft. While the exact cause is not fully understood, both genetic and environmental factors are believed to play a role. This condition occurs in approximately 1 in every 700 to 750 live births, with prevalence varying by ethnicity.
Prenatal Diagnosis and Counseling
When cleft lip and/or palate is detected through prenatal ultrasound, we provide prenatal counseling in partnership with the Department of Obstetrics and Gynecology. This support helps families prepare both emotionally and medically, alleviating anxiety and enabling early engagement in treatment.
Multidisciplinary Coordinated Care
From birth, patients receive comprehensive, staged care through a collaborative team that includes:
- Plastic Surgery
- Neonatology
- Otorhinolaryngology-Head and Neck Surgery (ENT)
- Pediatrics
- Orthodontics and Pediatric Dentistry
- Rehabilitation Medicine (Speech Therapy)
- Psychiatry and Clinical Psychology
This multidisciplinary network ensures continuity of care, supports healthy development, and provides emotional reassurance for both patients and their families.
Treatment Timeline Overview
From Birth to 2 Years
- Initial Evaluation : Genetic counseling and screening for other congenital anomalies
- Feeding Guidance : Individualized feeding techniques and devices
- Primary Lip Repair (Cheiloplasty): Around 10 weeks of age
- Primary Palate Repair (Palatoplasty): At 11–12 months
- ENT Collaboration : Screening for otitis media and insertion of tympanostomy tubes if necessary
- Speech Evaluation Begins : Around 3 weeks post-palate repair, followed by periodic assessments
Age 2 to 6 Years
- Speech Development Monitoring : Assessing for hypernasality or velopharyngeal insufficiency
- Secondary Surgery : Performed if speech problems persist, such as pharyngeal flap, palatal lengthening, or sphincter pharyngoplasty
- Psychosocial Support : Early interventions to address emotional responses to surgical experiences
- asal or Lip Revision : Performed before school entry to support psychosocial adjustment
Age 6 to 12 Years
- Alveolar Bone Grafting : Performed according to canine root development, typically in the early elementary years
- Dental and Orthodontic Care : For alignment and occlusion
- Secondary Aesthetic Revisions : Lip, nose, or scar corrections as needed
Age 12 to 18 Years
- Orthognathic (Jaw) Surgery : Performed for midfacial retrusion or jaw imbalance after skeletal growth is complete
- Final Rhinoplasty and Lip Revisions : Conducted after adolescence, once nasal cartilage and bone have matured
- Ongoing Follow-Up : Continued assessment of speech, orthodontics, and psychological well-being
Hospitalization & Postoperative Care
- Primary lip repair typically requires a short hospital stay of one to two nights
- Feeding can resume within hours postoperatively
- Nasal stents are worn for up to 6 months after surgery to help maintain nostril shape
- Suture removal and scar taping are performed during follow-up visits
- Parents are instructed on how to avoid touching the surgical site and how to monitor for potential complications
Speech and Language Outcomes
Children with cleft palate may experience speech difficulties even after surgery due to structural or muscular deficiencies. In such cases:
- Regular speech assessments are conducted
- Therapy is provided by trained speech-language pathologists
- Nasal stents are worn for up to 6 months after surgery to help maintain nostril shape
- Surgical intervention may be added based on speech outcomes
- Parents are instructed on how to avoid touching the surgical site and how to monitor for potential complications
Dental and Orthodontic Care
Children with cleft conditions often have:
- Missing, extra, or malformed teeth
- Poor alignment of upper and lower jaws
- Regular check-ups, impressions, radiographs, and braces provided by dental specialists
- Orthodontic preparation essential for alveolar bone grafting and orthognathic surgery
Nasal and Lip Revisions
- Cleft nasal deformity (cleft rhinoplasty) is commonly addressed before school entry (age 5–6), or earlier in severe cases
- Final nasal reconstruction is delayed until nasal growth is complete, typically in the late teens
- Lip scar revisions may be performed alongside nasal corrections or separately
Why Choose AMC for Cleft Care?
- Structured Long-Term Protocol : We provide a lifelong, phased roadmap for treatment with consistent follow-up at every developmental stage.
- Leading Surgical Techniques : Geometric cheiloplasty, primary rhinoplasty, and dynamic pharyngeal flaps tailored for both function and appearance.
- Integrated Family Support : Families receive not only surgical care, but also psychosocial, speech, and dental support.
- Trusted Expertise : Our plastic surgeons are global leaders in cleft and craniofacial reconstruction, combining precision, compassion, and interdisciplinary coordination.