Cleft Palate Surgery

Think of having an opening in the roof of your mouth. This is what happens in a cleft palate, a relatively common birth defect. A cleft palate occurs when there is a disconnect between the hard and soft palates of the mouth, thus creating a hole between the bony structural component of the mouth and the tissues and muscles that surround it. A cleft palate usually occurs in newborns due to pregnancy issues of mouth formation, and can make it difficult to eat, speak, and even breathe. 

As of now, palate surgery is the only option to fully treat this condition. Surgeons seal the opening between the palates using stitches in order for the newborn to resume normal functionality. This procedure, lasting 2-3 hours, typically takes place when the baby is between 9-18 months of age, allowing for the muscles and tissues to rehabilitate properly. 

This surgery involves heavy anesthesia use. The child will receive numbing medication from an anesthesiologist upon arrival and multiple anesthesiologists will be present throughout the surgery to ensure the child feels no pain. Surgeons then make incisions along the child’s palates in order to loosen the tissue surrounding them. 

The surgery finishes with the child’s palate being enclosed in a “Z” shape. This shape offers multiple benefits, including lengthening the soft palate. As any surgical incision heals, it shortens over time, but the soft palate must remain long to maintain the seal and allow the child to use their throat muscles. 

Once the child is moved to postoperative care, they must wear gentle arm braces to prevent damage of the stitches by putting unwanted objects in their mouth. The hospital will administer a special semi-liquid food diet for the child, in order to prevent solid food items from reopening the wound. Additionally, parents are taught how to feed and care for the child once they are discharged. Typically, the stitches dissolve on their own; however, follow-up appointments are usually made at periodic intervals.

The benefits of this procedure are numerous. Without it, many children would have to grow up with assisting methods like speech therapy, ear tubes, dental care, or additional surgeries to supplement deficiencies in speech and oral function.

However, access to this surgery is far from widespread. Many children in third-world countries are forced to live with a cleft palate due to financial restraints, making it very difficult for doctors to perform even the most mundane of tasks. Efforts to address this discrepancy have been made by various organizations, including Smile Train and Operation Smile. These organizations empower healthcare providers in underserved communities and engage in fundraising events to raise awareness on the issue and money for surgery. 

Cleft palate surgery has long been a staple of infant care and will continue to do so with the emerging technologies and a rising generation of plastic surgeons. Its simple nature and commonality make it one of the most successful surgery types, offering many infants the path to a healthy, ideal life.

Written by Saket Parayil at Incisionary

Cleft Palate Repair: The Surgery. (2016). Nationwidechildrens.org. https://www.nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/helping-hands/cleft-palate-repair-the-surgery

Mayo Clinic. (2022). Cleft lip and cleft palate - symptoms and causes.

Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/cleft-palate/symptoms-causes/syc-20370985

Next Stop, the Future of Cleft Care: (2021). Smile Train. https://www.smiletrainindia.org/strategic-plan

Redirect Notice. (2025). Google.com. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.plasticsurgery.org%2Freconstructive-procedures%2Fcleft-lip-and-cleft-palate-repair%2Fprocedure&psig=AOvVaw09P7etkkDJWU5wHTcZZIHp&ust=1753153080933000&source=images&cd=vfe&opi=89978449&ved=0CBgQjhxqFwoTCOiN7ar6zI4DFQAAAAAdAAAAABAE