Cleft Care

Cleft care at Palm Beach Plastic Surgery Institute is a comprehensive, patient-focused program designed to address the unique needs of individuals born with cleft lip and/or palate. This goes beyond the initial surgical repair of the cleft condition and includes ongoing treatments and procedures aimed at improving speech, dental alignment, and the overall appearance of the face. We also provide mental health and social services to patients with clefts and their families. Our team is led by a board-certified plastic surgeon with specialist fellowship training in cleft and craniofacial surgery and over a decade of experience. All surgical care is provided at the region’s leading children’s hospital by dedicated pediatric specialists.

What is cleft care?

Cleft care refers to the specialized medical and surgical treatments provided to individuals born with cleft lip and/or palate - congenital differences that occur when parts of the face do not join properly during early fetal development. Cleft care is a journey that begins even before birth; our team offers pre-natal meetings with expectant families to discuss what to expect, and we provide support and guidance during the perinatal period. Our multidisciplinary team cares for patients with clefts from initial cleft repair surgery through adolescence and adulthood with treatments designed to improve appearance, speech, dental health, and overall development.

We work as part of a multidisciplinary team including a cleft care coordinator, cleft surgeon, genetic counselor, geneticist, pediatric otolaryngologist (ENT), speech pathologist, pediatric dentist, orthodontist, audiologist, social worker, psychologist and pediatrician.

The goal of our team is to help your child achieve his/her full potential without being limited or defined by a facial difference.

Comprehensive cleft care: The cleft journey

Cleft care involves a range of procedures designed to improve the appearance and function of the mouth, teeth, and face. The critical treatments include:

Prenatal counselling

Sometimes a cleft lip and/or palate, or other craniofacial difference, is seen on a prenatal scan. Families, understandably, often have questions; What can we expect? Will our child be ‘normal’? How many surgeries will he/she have? Will he/she be able to feed, nurse. Our team is here to meet with you, answer questions so your family are ready and excited for your new arrival.

Cleft lip repair

A cleft in the lip is typically repaired at 3-6 months. Sometimes a lip “adhesion” or lip molding will be performed first for wide clefts to improve the result of lip repair. The reason for lip repair is appearance-related and should not affect feeding, breathing or speech.

Cleft palate repair

A cleft in the palate (or roof of the mouth) is typically repaired at around 12 months of age. The main reason for palate repair is to allow for the development of normal speech.

Secondary speech surgery

Sometimes, even after initial cleft repair, children may struggle with speech due to a condition known as velopharyngeal insufficiency (VPI). This is where the soft palate doesn't close against the back of the throat during speech, leading to hypernasality or nasal sounding speech. Secondary speech surgery aims to correct VPI, improving speech quality and clarity. This may be performed at any age, if a patient has developed VPI.

Alveolar bone grafting

Alveolar bone grafting is a procedure to repair the cleft in gum. This is typically performed when the child is 7 to 9 years old, depending on the pattern of tooth eruption. It involves adding bone to the gum ridge in the cleft area. This procedure can help stabilize the maxillary arch and support the permanent teeth, enhancing dental function and facial appearance.

Cleft orthognathic surgery

Orthognathic surgery, often undertaken in late adolescence, is used to correct significant jaw discrepancies that can be associated with cleft lip and palate conditions. This surgery can dramatically improve appearance and functional bite as well as prevent future kinematic alterations of the bite complex.

Cleft septorhinoplasty

Septorhinoplasty is a surgical procedure to improve the function and form of the nose in individuals affected by cleft lip and palate. The surgery, usually performed in adolescence or adulthood, can correct issues with nasal symmetry, septal deviation, and nostril shape, leading to improved aesthetic and functional outcomes.

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A Reconstructive Expert

Dr. Davidson discusses his dedication to reconstructive surgery.

Benefits of cleft care

The benefits of comprehensive cleft care extend far beyond physical appearance. Here are some key benefits:

Improved functionality: Procedures such as palate repair, speech surgery, orthognathic surgery and septorhinoplasty can significantly improve speech clarity, eating functionality, and breathing
Enhanced appearance: Surgeries like rhinoplasty and lip repair aim to enhance facial symmetry and aesthetics, boosting the individual's self-confidence.
Our cleft care program provides care that addresses not only physical but also psychological and social aspects of living with a cleft condition.

Who is a candidate for cleft care?

Individuals born with a cleft lip, cleft palate, or both can benefit from our comprehensive cleft care program. The specific treatments and timing will depend on the patient's age, overall health, and craniofacial condition.

At Palm Beach Plastic Surgery Institute, everyone deserves access to high-quality cleft care. That's why we've partnered with Palm Beach Plastic Surgery Foundation to provide financial assistance to those in need. We're committed to helping our patients overcome the challenges associated with cleft conditions and lead full, healthy lives.

Why choose Palm Beach Plastic Surgery Institute?

Choosing the Palm Beach Plastic Surgery Institute is choosing to prioritize safety, excellent results, and an exemplary overall patient experience. Our team is led by a board-certified plastic surgeon with specialist fellowship training in cleft and craniofacial surgery and over a decade of experience.

Its commitment to personalized care sets Palm Beach Plastic Surgery Institute apart. The boutique concierge practice ensures that each patient receives individualized attention, from the initial consultation to post-operative follow-ups.

When you choose Palm Beach Plastic Surgery Institute, you're not just choosing a medical service. You're choosing a team dedicated to your needs, compassionate in their approach, and committed to delivering the best possible results.